achalasia Flashcards

1
Q

define achalasia?

A

Failure of the oesophageal peristalsis and of relaxation of the lower oesophageal sphincter due to degenerative loss of ganglia from Auerbach’s plexus.

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2
Q

what is the aetiology of achalasia?

A

degeneration of the ganglion cells of the myenteric plexus in the oesophagus due to unknown cause

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3
Q

similar disease to achalasia?

A

CHAGAS DISEASE - this is an oesophageal infection with Trypanosoma cruzi seen in Central/South America

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4
Q

epidemiology of achalasia?

A

presents in middle age

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5
Q

presenting symptoms of achalasia?

A
INSIDIOUS onset and gradual progression 
•	Dysphagia involving BOTH solids and liquids 
•	Difficulty belching  
•	Regurgitation 
o	This can lead to cough, aspiration pneumonia 
•	Heartburn 
•	Chest pain 
•	Weight loss 
•	Halitosis
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6
Q

signs of achalasia on physical examination?

A

• May show signs of complications:
o Aspiration pneumonia
o Malnutrition
o Weight loss

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7
Q

investigations for achalasia?

A
  • CXR
  • Barium swallow
  • Endoscopy
  • Manometry
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8
Q

what might the CXR show>

A

o Widened mediastinum
o Double right heart border
o Air-fluid level in the upper chest
o Absence of the normal gastric air bubble

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9
Q

what might the barium swallow show?

A

o Dilated oesophagus which smoothly tapers down

o Birds beak appearance

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10
Q

what might the endoscopy rule out?

A

excludes malignancy

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11
Q

what might the manometry show?

A

o Elevated resting LOS pressure (> 45 mm Hg)

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12
Q

what antibodies are present in chugs disease?

A

antibodies against T. cruzi

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