Achalasia (A) and pneumatic dilatation (PD). A report from argentina

Salis, Graciela; Mazzadi, S; García, Artemio; Yance, P.; Chiocca, J.C

doi:10.1016/s0016-5085(00)83974-8

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“…One of the etiologic agents of achalasia in South America is Chagas disease, an esophageal infection caused by a protozoan of the genus Trypanosoma ( T. cruzi ). The incidence of this disorder is variable among South American countries; it is responsible for up to 90% of achalasia cases in Brazil, 4,5 causes between 18% and 23% of the cases in Argentina, 6,7 and 13% of cases in Chile 8 . Several Brazilian reports indicate that idiopathic achalasia and achalasia related to Chagas disease differ 9,10 .…”

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confidence: 99%

Pneumatic dilatation in achalasia of the esophagus: a report from Argentina

Salis

Mazzadi

García

et al. 2004

Diseases of the Esophagus

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We review the treatment of esophageal achalasia by means of pneumatic dilatation (PD), analyzing its results and comparing them with those of the literature. We conclude that our personal experience is similar to that of the literature: PD and surgery produce similar results (67-95%), morbidity (2-9.5%), and mortality (0.7-1%); and PD is cheaper than surgery. According to these conclusions, we believe that the decision of the appropriate treatment should be based on a combination of the choice of the properly informed patient and the operator's experience. However, we also conclude that surgery is mandatory in selected cases, such as achalasia associated with hiatus hernia, esophageal diverticula and neoplasia, history of previous PD failure (since in our experience the results after a second PD are very poor), postoperative relapse, and patients with grade IV mega-esophagus according to Resano-Malenchini's classification.

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