Sonographic findings in esophageal achalasia.
BACKGROUND
There are only three reports using conventional sonography to detect the gastroesophageal junction through the left lobe liver window in patients with achalasia, and the results were inconsistent. This study further characterizes the sonographic features of achalasia and compares them to characteristics of subjects with gastroesophageal malignancies.


METHODS
Conventional sonography was performed in 21 patients with achalasia (mean age 49.0 years, 11 male and 10 female, group A); 15 patients with malignancies at the gastroesophageal junction (n=10) and cardiac of the stomach (n=5) (mean age 55.3 years, 11 male and 4 female, group B); and 30 subjects with functional dyspepsia (mean age: 38.3 years, 15 male and 15 female, control group C).


RESULTS
The median esophageal wall thicknesses were 5.1+/-2.3 mm (group A), 19.5+/-7.8 mm (group B), and 3.3+/-1.2 mm (group C). However, there was overlap in the esophageal wall thickness in groups A and C. Sonographic features in group A were regular hypoechoic thickening of the wall at the gastroesophageal junction; in group B, we found irregular hypoechoic thickening of the wall. Control subjects had a regular hypoechoic gastroesophageal wall. Dilated lumens of the distal esophagus were seen in all achalasia patients.


CONCLUSIONS
Although conventional sonography is not a diagnostic tool for achalasia, it provides interesting sonographic information. It cannot reveal each layer of the wall of the lumen as endoscopic ultrasound does, but it may tentatively differentiate achalasia from malignancies and assists clinicians when endoscopic ultrasound is not available.
Chuah
Seng-Kee
SK
Division of Hepato-gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan. chuahsk@seed.net.tw
Hu
Tsung-Hui
TH
Wu
Keng-Liang
KL
Tai
Wei-Chen
WC
Chen
Tai-Yi
TY
Chiu
Yi-Chun
YC
Hu
Ming-Luen
ML
Changchien
Chi-Sin
CS
Lee
Chuan-Mo
CM
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D004931:Esophageal Achalasia / Q000000981:diagnostic imaging*; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging; D004943:Esophagogastric Junction / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014463:Ultrasonography