Treatment of esophagogastric junction outflow obstruction with concomitant hypercontractile esophagus: A case series.

Autor: Benson AA; Institute of Gastroenterology and Liver Diseases, Department of Internal Medicine, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. ari.benson@gmail.com., Khoury T; Department of Gastroenterology, Gallilee Medical Center, Nahariya, Israel.; Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel., Feldman D; Department of Gastroenterology, Hillel Yaffe Medical Center, Hadera, Israel., Mintz Y; Department of General Surgery, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Herschcovici T; Institute of Gastroenterology and Liver Diseases, Department of Internal Medicine, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Jazyk: angličtina
Zdroj: Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology [Indian J Gastroenterol] 2023 Jun; Vol. 42 (3), pp. 431-435. Date of Electronic Publication: 2023 Apr 28.
DOI: 10.1007/s12664-022-01267-y
Abstrakt: Hypercontractile esophagus with concomitant esophagogastric junction outflow obstruction (EGJOO) is a rare entity that is characterized by both esophageal hypercontractility and lack of relaxation of the EGJ. The clinical characteristics of these patients are not well-described and there is no strict recommendation regarding the treatment of this condition. We report four cases of patients with hypercontractile esophagus and concomitant to EGJOO. All patients underwent upper gastrointestinal (GI) endoscopy, high-resolution esophageal manometry (HRM) and barium swallow and met the criteria of Chicago Classification for both EGJOO and hypercontractile esophagus. Patients were followed up to four years from diagnosis and clinical symptoms were recorded. Four patients, who underwent evaluation for dysphagia, were found to have both EGJOO and hypercontractile esophagus on HRM. Two of them had mild symptoms and did not undergo treatment with no progression of symptoms on follow-up. Of the two patients who underwent treatment, one had botulinum toxin injection to the EGJ via upper GI endoscopy and one underwent per-oral endoscopic myotomy. Symptoms in both patients improved. Patients with concomitant hypercontractile esophagus and EGJOO present with varying degrees of symptoms and the treatment approach should be personalized according to the degree of symptoms and general clinical condition.
(© 2022. Indian Society of Gastroenterology.)
Databáze: MEDLINE