Is it necessary to perform a morphological assessment for an esophageal motility disorder? A retrospective descriptive study - 11/11/21
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Highlights |
• | The literature about secondary forms of esophagus motor disorders at the exception of achalasia is limited. |
• | In our study, 8.8% of esophagus motor disorder were identified as secondary thanks to CT-scan and/or endoscopic ultrasound, of which 4.4% were malignant. |
• | Risk factors of secondary causes identified were age, tobacco consumption and high Integrated Relaxation Pressure of the lower esophageal sphincter. |
Abstract |
Background |
Esophageal motility disorders are most often of primary origin but may be secondary to an occult malignancy or another etiology. High-resolution esophageal manometry cannot differentiate between secondary or primary origin. This study aimed at discussing the usefulness of a morphological assessment in the diagnosis of specific esophageal motility disorders, and to establish the predictive factors of a potential secondary origin.
Methods |
In this retrospective study, patients with suspected esophageal motility disorders who underwent an esophageal manometry were included. High-resolution manometry results were interpreted according to the Chicago Classification, 3rd version. The results of endoscopic ultrasound and computed tomography, assessed by a panel of experts, allowed to diagnose a secondary origin.
Key Results |
Out of 2138 patients undergoing manometry, 502 patients had a esophageal motility disorder suspect to be from secondary origin; among them 182 patients underwent tomography or endoscopic ultrasound. According to experts, 16 patients (8.8%) had a secondary esophageal motility disorder: esophagogastric junction outflow obstruction (n = 7), jackhammer disorder (n = 4), achalasia (n = 3) and localized pressurization (n = 2). The etiology was malignant in 8 patients. Predictive factors suggesting potential secondary esophageal motility disorders were smoking, age ≥ 58 years and an Integrated Relaxation Pressure higher than 10 mmHg for water swallows.
Conclusion and Inferences |
Esophageal motility disorders with organic origin are not uncommon. A morphological assessment using endoscopic ultrasonography and/or computed tomography may be of use to diagnose a secondary origin, especially in the elderly and smokers.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Esophageal motility disorders, Achalasia, Tomography, Endosonography, Manometry, Etiology
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Vol 45 - N° 6
Articolo 101633- Novembre 2021 Ritorno al numero
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