6533b861fe1ef96bd12c578e

RESEARCH PRODUCT

Dolichomegaösophagus bei Achalasie

Th. JungingerInes GockelWilfried RothVolker F. Eckardt

subject

medicine.medical_specialtymedicine.diagnostic_testbusiness.industrydigestive oral and skin physiologyAchalasiaGeneral Medicinemedicine.diseaseDysphagiadigestive system diseasesSurgeryEndoscopymedicine.anatomical_structureWeight lossDilatorotorhinolaryngologic diseasesmedicineDecompensationReflux esophagitismedicine.symptomEsophagusbusiness

description

HISTORY AND CLINICAL FINDINGS A 78-year-old woman suffered from achalasia since 63 years with a progressive decompensation over the last year. 53 years ago, treatment with the Stark Dilator and 24 years ago, pneumatic dilation had been carried out. Currently, the patient presented with dysphagia for liquid and solid food, with permanent retrosternal pain and regurgitation for every meal, leading to a weight loss of 10 kg. INVESTIGATIONS The barium esophagogram showed a marked dilation of the esophagus with retinated secretions and food. The cardia had a maximum width of 15 mm. On endoscopy, reflux esophagitis and an insufficient lower esophageal sphincter were evident. TREATMENT AND COURSE Transhiatal esophageal resection with gastric pull-up and cervical esophagogastrostomy was performed. The postoperative course was without complications and normal alimentation could be restored with a marked improvement of preoperative symptoms. CONCLUSION Esophageal resection and gastric pull up is the more favourable treatment option in elderly patients with decompensated achalasia and dolichomegaesophagus compared to a gastric tube for alimentation--adjusted to the individual surgical risk.

yearjournalcountryeditionlanguage
2004-04-01DMW - Deutsche Medizinische Wochenschrift
https://doi.org/10.1055/s-2004-821378