title: High-resolution manometry findings in patients with achalasia and massive dilated megaesophagus.
abstract: Achalasia may present in a non-advanced or an advanced (end stage) stage based on the degree of esophageal dilatation. Manometric parameters and esophageal caliber may be prognostic for the outcome of treatment. The correlation between manometry and disease stage has not been yet fully studied. This study aims to describe high-resolution manometry findings in patients with achalasia and massive dilated megaesophagus. Eighteen patients (mean age 61 years, 55% females) with achalasia and massive dilated megaesophagus, as defined by a maximum esophageal dilatation >10 cm at the barium esophagram, were studied. Achalasia was considered secondary to Chagas' disease in 14 (78%) of the patients and idiopathic in the remaining. All patients underwent high-resolution manometry. Upper esophageal sphincter was hypotonic and had impaired relaxation in the majority of patients. Aperistalsis was seen in all patients with an equal distribution of Chicago type I and type II. No type III was noticed. Lower esophageal sphincter did not have a characteristic manometric pattern. In 50% of the cases, the manometry catheter was not able to reach the stomach. Our results did not show a manometric pattern in patients with achalasia and massive dilated esophagus.
authors.affiliation: Department of Surgery, Escola Paulista de Medicina, Federal University of São Paulo, Sao Paulo, Brazil.
authors.forename: M A
authors.initials: MA
authors.lastname: Menezes
authors.affiliation: Department of Surgery, University of Chicago, Illinois, USA.
authors.forename: C
authors.initials: C
authors.lastname: Andolfi
authors.affiliation: Department of Surgery, Escola Paulista de Medicina, Federal University of São Paulo, Sao Paulo, Brazil.
authors.forename: F A M
authors.initials: FA
authors.lastname: Herbella
authors.affiliation: Department of Surgery, University of Chicago, Illinois, USA.
authors.forename: M G
authors.initials: MG
authors.lastname: Patti
mesh_terms: D014355:Chagas Disease / Q000150:complications; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000209:etiology; D004931:Esophageal Achalasia / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D049630:Esophageal Sphincter, Lower / Q000000981:diagnostic imaging / Q000473:pathology; D049631:Esophageal Sphincter, Upper / Q000000981:diagnostic imaging / Q000473:pathology; D004947:Esophagus / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods*; D008875:Middle Aged; D011379:Prognosis; D011859:Radiography / Q000379:methods; D012189:Retrospective Studies
keywords: Chagas’ disease; achalasia; manometrymegaesophagus