title: [Circumscribed venous ectasia of the upper esophagus and "downhill" varices in primary disorders of esophageal motility].
abstract: Felson and Lessure 1964 (1) described varicosities involving the upper third of the esophagus in patients without portal hypertension. Several etiological factors causing these "downhill" varices, e.g. bronchogenic carcinoma, retrosternal thyroid adenoma or mediastinal fibrosis, have been described. Since September 1989 ectatic esophageal veins or "downhill" varices were diagnosed in nine patients with dysphagia and/or non cardiac chest pain. Intrathoracic masses as a possible cause of "downhill" varices could not be diagnosed in any of these patients. Endoscopy of the upper gastro-intestinal tract revealed spiral esophageal contractions as a potential sign of a esophageal motor disorder in seven patients. By means of esophageal manometry "nutcracker"-esophagus was seen in two patients and diffuse esophageal spasm in three patients. On the basis of these findings primary esophageal motor disorders should be considered as a possible cause of ectatic veins in the proximal esophagus and "downhill" varices.
authors.affiliation: Abteilung für Gastroenterologie und Hepatologie, Universitätsklinik Bergmannsheil Bochum, Bundesrepublik Deutschland.
authors.forename: G H
authors.initials: GH
authors.lastname: Micklefield
authors.forename: U
authors.initials: U
authors.lastname: Schwegler
authors.forename: D
authors.initials: D
authors.lastname: Hüppe
authors.forename: A
authors.initials: A
authors.lastname: Wittenborg
authors.forename: V
authors.initials: V
authors.lastname: Wiebe
authors.forename: B
authors.initials: B
authors.lastname: May
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy; D015154:Esophageal Motility Disorders / Q000150:complications* / Q000175:diagnosis; D015155:Esophageal Spasm, Diffuse / Q000150:complications / Q000175:diagnosis; D004940:Esophageal Stenosis / Q000150:complications / Q000175:diagnosis; D004932:Esophageal and Gastric Varices / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
vernacular_title: Umschriebene Venektasien im oberen Osophagus und "Downhill"-Varizen bei primären Störungen der Osophagusmotilität.