Achalasia. Study of 27 cases at the "Rafael A. Calderón Guardia" Hospital
DOI:
https://doi.org/10.51481/amc.v45i1.89Keywords:
Acalasia, esófago enfermedades, esofagocardiomiotomíaAbstract
This is a retrospective study of the clinical records of 27 pa-tients diagnosed with achalasia at the Dr. R. A. CalderónGuardia Hospital during a period of eleven years from 1991to 2001. The ratio was of 0.3 per 100.000 inhabitants whichis less than the one found in the literature. This is probablydue to the absence of esophageal manometry studies whichmakes difficult the diagnosis of these patients in early stagesor with low or moderate symptoms of the disease. The clini-cal presentation was similar to that reported by other authors,with a ratio men to women of 1.7 to 1 and an average age of42 years. The symptoms had an average of 7 years,dispha-gia being the primary one,present in all cases. This was fo-llowed by vomiting,thoracic pain,weight loss and gastroe-sophageal reflux. The esophagoscopy and esophagogramshowed data of advanced achalasia such as esophageal dilata-tion,retention of alimentary rests,and cardial spasm,wichwas easily forced opened with the endoscope. The treatmentwas only medical (Nifedipine and Isordil) in six patients,di-latations and medical in seven patients,and surgical (esopha-gomiotomy) in fourteen patients,three of them also had ananti reflux procedure. The patients treated medically and withdilatations continued to be symtomatic. Of the operated ones,there was a patient who required dilatations five and nineyears after surgery. Two,who did not have an anti reflux pro-cedure are under treatment for this problem,the rest areasymptomatic without any surgical complications.
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