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- Title
Clinical, Endoscopic, and Radiologic Features of Three Subtypes of Achalasia, Classified Using High-Resolution Manometry.
- Authors
Khan, Mohammed Q.; AlQaraawi, Abdullah; Al-Sohaibani, Fahad; Al-Kahtani, Khalid; Al-Ashgar, Hamad I.
- Abstract
Background/Aims: High-resolution manometry (HRM) has improved the accuracy of manometry in detecting achalasia and determining its subtypes. However, the correlation of achalasia subtypes with clinical, endoscopic, and radiologic findings has not been assessed. We aimed to evaluate and compare the clinical, endoscopic, and fluoroscopy findings associated with three subtypes of achalasia using HRM. Patients and Methods: The retrospective clinical data, HRM, endoscopy, and radiologic indings were obtained from the medical records of untreated achalasia patients. Results: From 2011 to 2013, 374 patients underwent HRM. Fifty-two patients (14%) were diagnosed with achalasia, but only 32 (8.5%) of these patients had not received treatment and were therefore included in this study. The endoscopy results were normal in 28% of the patients, and a barium swallow was inconclusive in 31% of the achalasia patients. Ten patients (31%) were classiied as having type I achalasia, 17 (53%) were classiied as type II, and 5 (16%) were classified as type III. Among the three subtypes, type I patients were on average the youngest and had the longest history of dysphagia, mildest chest pain, most significant weight loss, and most dilated esophagus with residual food. Chest pain was most common in type III patients, and frequently had normal fluoroscopic and endoscopic results. Conclusion: The clinical, radiologic, and endoscopic findings were not significantly different between patients with type I and type II untreated achalasia. Type III patients had the most severe symptoms and were the most difficult to diagnose based on varied clinical, radiologic, and endoscopic findings.
- Subjects
SAUDI Arabia; BARIUM; ESOPHAGEAL achalasia; STATISTICAL correlation; ENDOSCOPY; FISHER exact test; MANOMETERS; STATISTICS; DATA analysis; RETROSPECTIVE studies; SEVERITY of illness index; DATA analysis software; DESCRIPTIVE statistics; KRUSKAL-Wallis Test; THERAPEUTICS
- Publication
Saudi Journal of Gastroenterology, 2015, Vol 21, Issue 3, p152
- ISSN
1319-3767
- Publication type
Article
- DOI
10.4103/1319-3767.157560