title: Transition from peristaltic esophageal contractions to diffuse esophageal spasm.
abstract: A patient with dysphagia and chest pain was shown by manometry to have high-amplitude peristaltic esophageal contractions (nutcracker esophagus). Worsening symptoms over the next two years led to the performance of repeated manometric studies, which showed diffuse esophageal spasm. This demonstration of a transition from nutcracker esophagus to diffuse esophageal spasm lends further support for consideration of the nutcracker esophagus as a manometric disorder associated with chest pain or dysphagia. Furthermore, it suggests a pathophysiologic relationship between the nutcracker esophagus, a disorder with preserved peristalsis, and diffuse esophageal spasm, the classic dysmotility considered to be of neurogenic origin.
mesh_terms: D003680:Deglutition Disorders / Q000209:etiology; D004935:Esophageal Diseases / Q000503:physiopathology*; D004947:Esophagus / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010528:Peristalsis; D011312:Pressure; D013035:Spasm / Q000503:physiopathology; D013909:Thorax; D013997:Time Factors