Achalasia ultrasound: Difference between revisions

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{{Achalasia}}
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{{CMG}} {{AE}} {{TS}} {{AY}}
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==Overview==
==Overview==
Achalasia should be differentiated from mechanical obstruction or neoplastic infiltration of [[lower esophageal sphincter]] which can present with similar symptoms such as [[dysphagia]], [[regurgitation]] and [[weight loss]].  [[Endoscopic ultrasound]] is required in cases where [[malignancy]] is suspected.<ref name="pmid23877351">{{cite journal| author=Vaezi MF, Pandolfino JE, Vela MF| title=ACG clinical guideline: diagnosis and management of achalasia. | journal=Am J Gastroenterol | year= 2013 | volume= 108 | issue= 8 | pages= 1238-49; quiz 1250 | pmid=23877351 | doi=10.1038/ajg.2013.196 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23877351  }} </ref> 
[[Endoscopic ultrasound]] is required in cases where [[malignancy]] is suspected.
 
==Endoscopic Ultrasound==
==Endoscopic Ultrasound==
[[Endoscopic ultrasound]] (EUS) is indicated in cases of achalasia like picture with strong suspicion of malignancy. Presence of following risk factors raises suspicion for malignancy:
[[Endoscopic ultrasound]] (EUS) is indicated in cases of achalasia with strong suspicion of malignancy. The presence of the following risk factors raises suspicion for malignancy:<ref name="pmid23877351">{{cite journal| author=Vaezi MF, Pandolfino JE, Vela MF| title=ACG clinical guideline: diagnosis and management of achalasia. | journal=Am J Gastroenterol | year= 2013 | volume= 108 | issue= 8 | pages= 1238-49; quiz 1250 | pmid=23877351 | doi=10.1038/ajg.2013.196 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23877351  }} </ref>
* Elderly patients
* Elderly patients
* Short duration of [[dysphagia]] history
* Short duration of [[dysphagia]] history

Latest revision as of 15:33, 27 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Twinkle Singh, M.B.B.S. [2], Ahmed Younes M.B.B.CH [3]

Overview

Endoscopic ultrasound is required in cases where malignancy is suspected.

Endoscopic Ultrasound

Endoscopic ultrasound (EUS) is indicated in cases of achalasia with strong suspicion of malignancy. The presence of the following risk factors raises suspicion for malignancy:[1]

  • Elderly patients
  • Short duration of dysphagia history
  • Significant weight loss
  • Unusually increased resistance to passage of endoscope through gastroesophageal junction

Unusual thickening of gastroesophageal junction, mass lesions or neoplastic infiltration revealed on EUS suggests diagnosis of pseudoachalasia instead of achalasia.[2]

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References

  1. Vaezi MF, Pandolfino JE, Vela MF (2013). "ACG clinical guideline: diagnosis and management of achalasia". Am J Gastroenterol. 108 (8): 1238–49, quiz 1250. doi:10.1038/ajg.2013.196. PMID 23877351.
  2. Boeckxstaens GE, Zaninotto G, Richter JE (2013). "Achalasia". Lancet. doi:10.1016/S0140-6736(13)60651-0. PMID 23871090.

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