Achalasia other imaging findings: Difference between revisions
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==Other Imaging Findings== | ==Other Imaging Findings== | ||
[[Esophagogastroduodenoscopy]] is complementary to [[manometry]] in diagnosing achalasia. It is indicated primarily to rule out any mechanical obstruction or pseudoachalasia (neoplastic iniltration). | |||
==Esophagogastroduodenoscopy== | |||
* Most patients should get an EGD – primarily in order to rule out any mechanical obstruction and malignancy (esophageal and gastric). | |||
*:* Findings include a dilated esophagus with residual food fragments, normal mucosa and occasionally [[candidiasis]](due to the prolonged stasis). | |||
*:* Factors associated with an increased risk of [[malignancy]] include symptoms less than 6 months, presentation after 60 years old, excessive weight loss and difficult passage of the endoscope through the [[gastroesophageal junction]]. | |||
* In cases diagnosed with GERD, endoscopic findings of dilated esophagus, retained food in esophagus can help diagnose achalasia correctly. | |||
* In cases undergoing endoscopy for dysphagia, esophageal biopsies are recommended to rule out eosinophilic esophagitis. However if the endoscopic picture is very clear for achalasia, biopsy is not recommended.<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> | |||
'''Achalasia in a patient with Allgrove syndrome''' | '''Achalasia in a patient with Allgrove syndrome''' | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Other Imaging Findings
Esophagogastroduodenoscopy is complementary to manometry in diagnosing achalasia. It is indicated primarily to rule out any mechanical obstruction or pseudoachalasia (neoplastic iniltration).
Esophagogastroduodenoscopy
- Most patients should get an EGD – primarily in order to rule out any mechanical obstruction and malignancy (esophageal and gastric).
- Findings include a dilated esophagus with residual food fragments, normal mucosa and occasionally candidiasis(due to the prolonged stasis).
- Factors associated with an increased risk of malignancy include symptoms less than 6 months, presentation after 60 years old, excessive weight loss and difficult passage of the endoscope through the gastroesophageal junction.
- In cases diagnosed with GERD, endoscopic findings of dilated esophagus, retained food in esophagus can help diagnose achalasia correctly.
- In cases undergoing endoscopy for dysphagia, esophageal biopsies are recommended to rule out eosinophilic esophagitis. However if the endoscopic picture is very clear for achalasia, biopsy is not recommended.[1]
Achalasia in a patient with Allgrove syndrome
Cricopharyngeal achalasia
References
- ↑ 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.