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At least 505 records · Page 28Linked to original sources
PubMed1979

[Association of idiopathic megaesophagus and carcinoma].

In the light of three cases of esophageal carcinoma developing on a pre-existing idiopathic megaesophagus the authors examine etiopatological, clinical and terapeutic problems related to this association. They believe that carcinoma of the esophagus tends to be a complication of cardiospasm in patients inadequately treated for the primary condition. Early diagnosis and an adequate Heller operation for cardiospasm will lessen the chance of cancer developing in megaesophagus with stasis. When finally diagnosed, this variety of esophageal carcinoma has an extremely poor prognosis. An even more important claim upon the clinician is to be alert to the hazards of continued stasis in megaesophagus and to devise earlier techniques of recognition, including more frequent recourse to biopsy during esophagoscopy.

Aged↗
PubMedDate not supplied

The effects of acute oesophageal distension on arterial blood pressure, E.C.G. and respiration in dog.

Anginal pain is a common clinical finding during cardiospasm or during pneumatic dilatation of oesophagus to relieve cardiospasm. Thus the present work was taken up to find out any relationship between the oesophagus and the cardiovascular system during experimental distension of the oesophagus in dogs. Pneumatic distension of oesophagus was done in anaesthetised dogs and its effects on arterial blood pressure, E.C.G. and respiration were studied. A fall in arterial blood pressure was observed in almost all dogs during distension. E.C.G. changes like a reduction in the 'R' wave voltage, absence of 'R' wave and a shift in the isoelectric line were observed also during distension. Moreover, oesophageal distension produced a transient apnoea in almost all animals and they seemed to be in a respiratory distress. When the distension was continued, the arterial blood pressure instead of remaining low, came back to the control or even higher level inspite of the presence of distension. Bilateral vagotomy did not abolish the hypotensive effect and E.C.G. changes but abolished the increase of blood pressure during the later part of distension. The cardiovascular changes were considered to be of a reflex nature and besides the vagi, the sympathetics seem to play an important role in this.

Animals↗
PubMed1983

[Swallowing the psyche].

Various swallowing disorders have been viewed to be psychogenic and an altered contractile activity of the oesophagus has been reported to occur during emotional stress. Non-propulsive activity and "cardiospasm" were suggested to represent a symbolic revulsion, referring to deep, unconscious conflict or an ambivalent attitude towards incorporation (Kronfeld, 1934; Weiss, 1944; Alexander, 1950). However, these concepts were not corroborated by subsequent research. "Globus hystericus" was shown to result from webs and folds in the hypopharynx or from gastrooesophageal reflux, whilst the term "cardiospasm" has even become obsolete: there is no spasm of the lower oesophageal sphincter but an "achalasia", i.e., a failure to relax upon swallowing, which is not induced by psychic factors, but by lesions affecting the intrinsic and extrinsic innervation. On the other hand, it has been shown that the oesophagus reacts with non-propulsive contractions not only emotional tension, but also to cold or hot food and even to stimuli not related to ingestion such as intense short sounds, and that these contractions are likely to form part of the defence reaction of the healthy organism. Despite this responsiveness of the oesophagus and the fact that strategies aimed at inducing relaxation and reassurance can help patients to cope with their swallowing disorders, the psychosomatic concept that "exaggerated" oesophageal responses can lead to organic diseases has remained purely speculative. Present knowledge of the physiology and pathophysiology of the oesophagus clearly indicates that disorders such as globus sensation, achalasia, and diffuse oesophageal spasm should not be treated by psychotherapeutic but by appropriate surgical, or medical, means.

Acoustic Stimulation↗
PubMed1982

[Functional obstruction of the cardia and cancer localized in the cardia and esophagus].

The work is based on the experience with the exploration and treatment of 310 patients with the functional obstruction of the cardia which are found to have two pathogenetic forms-cardiospasm and cardiac achalasia. Errors in the diagnosis in the outpatient department were 38%. Causes of the diagnostic errors and the differential-diagnostic tables are given. Against the background of the continuous course of cardiospasm and cardiac achalasia there appeared carcinoma of the cardiac-esophageal localization in 2,5% of cases. All the patients subjected to operations or instrumental cardiodilatation who have gastro-esophagal reflux should be taken under special control with periodic endoscopic examinations.

Adult↗
PubMed1975

[Diagnostic possibilities of fibroesophagoscopy and target biopsy of the esophagus].

The results from the 195 performed fibroesophagoscopies and 114 purposeful biopsies in different esophgus diseases are reported. In 65 of the examined -- cancer of the esophagus or cardia ventriculi was establised. The rest 122 patients are with non-malignant disease -- ulcers, polyps, diverticulums, varices, strictures, esophagitis, cardiospasm, etc. Cancer of esophagus and cardia ventriculi is proved in 93.93 per cent on the base of endoscopic data while another diagnosis was given in 29.30 per cent at the X-ray examinations of the same patients and at the clinical examinations of the patients in 40.1 per cent -- diagnostic errors were made. The purposeful biopsy gives 70.58 per cent of positive results and enables the differentiation of the tumor histological characterisitics.

Adolescent↗
PubMedDate not supplied

[Late results after the Mark Belsey IV antireflux procedure in achalasia].

Cardial achalasia (cardiospasm, megaesophagus) represents the failure or lack of relaxation capacity of the inferior esophageal sphincter; it is the second esophageal disease and is considered a premalignant lesion. Treatment of achalasia is surgical but palliative, considering the lack of an etiopathogenic therapy for this moment. We present a retrospective study done on 19 patients (10 males and 9 females, with a mean age of 49 years) operated in "Colentina" Surgical Clinic in the period of 1996-1999 for achalasia (presenting symptoms-dysphagia, regurgitation, weight loss) by extramucosal esocardiomyotomy practiced on a length of 5-10 cm, by thoracic approach, followed by the Mark Belsey IV antireflux procedure. Results were good, without reflux pathology or dysphagia in the postoperative evolution.

Adult↗