title: "Nutcracker" esophagus: diagnosis with radionuclide esophageal scintigraphy versus manometry.
abstract: "Nutcracker" esophagus is a syndrome consisting of chest pain and/or dysphagia with elevation of the mean distal esophageal contractile pressure amplitude (MDA) (greater than 120 mm Hg). Its existence as a disorder of esophageal function and the proper manometric diagnostic criteria have been debated. A correlative study of radionuclide esophageal scintigraphy (RES) and manometry was performed in 31 patients with this manometric diagnosis. RES results were abnormal in 13 of 16 (81%) patients with an MDA above 150 mm Hg, and in only three of 15 (20%) patients with an MDA below this level. There was a significant difference in RES parameters (mean transit time and percentage emptying) between these two groups. Repeat manometric and RES studies showed considerable variability, but only RES showed a significant correlation between baseline and repeat studies. RES confirms a functional disorder in a subgroup of patients with the manometric diagnosis of nutcracker esophagus and supports a change in the manometric criteria for diagnosis of this disorder to an MDA above 150 mm Hg.
mesh_terms: D002637:Chest Pain / Q000209:etiology*; D003680:Deglutition Disorders / Q000209:etiology*; D004935:Esophageal Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D004947:Esophagus / Q000503:physiopathology; D006801:Humans; D008365:Manometry; D010528:Peristalsis; D011877:Radionuclide Imaging; D013671:Technetium Tc 99m Sulfur Colloid
chemical_list: D013671:Technetium Tc 99m Sulfur Colloid