Evolutive radiological changes of the esophagus in patients with achalasia who did not receive treatment.
OBJECTIVE
The radiological features of achalasia of the esophagus are well known and have been described. However, very little is known concerning the natural history of this disease. We aimed to determine the evolutive radiological changes of the esophagus in a group of patients with achalasia who had not previously undergone any treatment.


METHODS
We undertook a prospective study of 14 patients with achalasia from a group of 205 patients. They included 9 women and 5 men who did not receive any treatment at the initial diagnosis. Two radiological parameters were evaluated: (a) the maximal internal diameter of the middle third of the thoracic esophagus in millimeters and (b) the internal diameter of the esophagogastric junction in millimeters.


RESULTS
At a mean follow-up of 5-years without any treatment, there was a significant increase in the diameter of the thoracic esophagus, with a rate of "dilatation" of 6.1 mm/year. In addition, there was a significant decrease of the internal diameter of the esophagogastric junction, with a rate of "stenosis" of 1 mm/year. The lower esophageal sphincter was hypertensive in all with an incomplete relaxation.


CONCLUSIONS
These results suggest that there is a progressive deterioration in the radiological parameters of the esophagus in patients with achalasia not treated over a 5-year period of observation.
Csendes
Paula
P
Department of Surgery and Radiology, Clinical Hospital, University of Chile, Santos Dumont #999, Santiago, Chile.
Csendes
Attila
A
Cortes
Claudio
C
Burgos
Ana Maria
AM
D000328:Adult; D000368:Aged; D018450:Disease Progression; D004931:Esophageal Achalasia / Q000000981:diagnostic imaging* / Q000628:therapy; D004947:Esophagus / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography