• Destruction of nerves to LES.
• Muscles of esophagus and LES both are affected.
• Failure of LES relaxation and aperistalsis of esophageal body.
C/F :-
• Triad - Dysphagia, Regurgitation and Weight loss.
• Nocturnal coughing.
Diagnosis :-
• Barium swallow - Bird beak, Pencil tip or Rat tail sign.
• Mecholyl test - +ve
• CCK test - +ve
• Manometry - Gold std.
LES - Absent LES relaxation (<75%)
Esophageal body - Elevated intraesophageal pressure (>100 mm Hg), Simultaneous mirrored contractions
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T/t :-
• Subligual Nitroglycerine, Nitrates, CCB.
• Bougie dilation
• Botox
• Lap Heller Myotomy - Op of choice
• Toupet or Dor fundoplication
• Muscles of esophagus and LES both are affected.
• Failure of LES relaxation and aperistalsis of esophageal body.
C/F :-
• Triad - Dysphagia, Regurgitation and Weight loss.
• Nocturnal coughing.
Diagnosis :-
• Barium swallow - Bird beak, Pencil tip or Rat tail sign.
• Mecholyl test - +ve
• CCK test - +ve
• Manometry - Gold std.
LES - Absent LES relaxation (<75%)
Esophageal body - Elevated intraesophageal pressure (>100 mm Hg), Simultaneous mirrored contractions
Like our FB page to stay updated - Cortex Mednotes
T/t :-
• Subligual Nitroglycerine, Nitrates, CCB.
• Bougie dilation
• Botox
• Lap Heller Myotomy - Op of choice
• Toupet or Dor fundoplication
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