The hypertensive lower esophageal sphincter
| Autor: | Paul R. Hinder, Thomas R. McGinn, N. Katada, Ronald A. Hinder, Galen Perdikis, Rebecca A. Stalzer, Richard J. Lund |
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| Rok vydání: | 1996 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Manometry Achalasia Neurological disorder Gastroenterology Internal medicine medicine Humans Esophageal Motility Disorders Esophagus Aged Aged 80 and over Esophageal disease business.industry Reflux Nutcracker esophagus General Medicine Middle Aged medicine.disease medicine.anatomical_structure Hypertension Hypertonia Female Surgery Esophageal spasm Esophagogastric Junction medicine.symptom business Follow-Up Studies |
| Zdroj: | The American Journal of Surgery. 172:439-443 |
| ISSN: | 0002-9610 |
| DOI: | 10.1016/s0002-9610(96)00219-x |
| Popis: | Background This study defines the entity of the hypertensive lower esophageal sphincter (HLES) and its treatment, including surgical implications. Methods Esophageal manometry was performed on 1,300 patients. Of these, 53 (4%) had HLES with resting pressure >26.5 mm Hg, defined as the upper limit of normal resting LES pressure. Thirty-two of these patients had 24-hour esophageal pH studies. The response to treatment was assessed. Results Fourteen patients (26%) with HLES had achalasia. Of the remaining 39 (74%), 25 had an isolated HLES with normal esophageal body motility, 5 had a nonspecific esophageal motiliry disorders (NEMD), 4 were post-Nissen fundoplication, 3 had a nutcracker esophagus, and 2 had diffuse esophageal spasm (DES). Nineteen percent of HLES patients had gastroesophageal reflux on pH studies. Eighty-two percent of HLES patients responded well to symptom-directed medical therapy. Two patients with esophageal body dysmotility responded well to an esophageal myotomy with a partial fundoplication. Conclusions Patients with the HLES form a heterogeneous group. Gastroesophageal reflux in HLES patients is not uncommon. Patients with HLES respond well to medical therapy. Carefully selected patients require surgery. |
| Databáze: | OpenAIRE |
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