Cardiospasm

Abstract

THE disease called 'cardiospasm' is a diffuse abnorma-with the Negus hydrostatic dilator or Heller's operality of oesophageal motility. The cause is not known tion. Heller's operation was undertaken in 26 patients, and it is not known whether the pathological changes 15 of them female. From the graph it would appear in the established case are primary or secondary. The that a disproportionately large number of young majority of patients with cardiospasm die before their females were submitted to cardiomyotomy. The onset expected age of survival (Ellis, 1960) and as a direct of symptoms in cardiospasm is, however, common in consequence of one of the complications of the adolescents, the incidence of cardiospasm is slightly

Oesophageal Dyskinesia

“…Abnormal movements in the body of the achalasia gullet, somewhat similar to tertiary waves previously described, were reported by Johnstone in 1956, and it has been shown that these abnormal spasms are, as it were, uncovered by Heller's operations (Wright, 1961) and in some cases it seems likely that these spasms have been the cause of post-operative dysphagia (Le Roux and Wright, 1961). These spasms can be classified into three types :…”

“…It was the opinion of Hurst and Rake (1929-30) that the cardiac sphincter failed to relax because of the absence of ganglion cells at that site, and that the dilatation of the gullet proximal to this was secondary. Some doubt has been cast on the observation of Rake that the narrowed segment is aganglionic, by the fact that Buscopan, a ganglion blocking drug, produces some widening of the narrowed portion and emptying of the gullet in the erect position (Wright, 1961) (Figures 8 (a), (b) and (c)). The work of Trounce, Deucher, Kauntze and Thomas (1957) is particularly relevant.…”

Results of Heller's operation for achalasia of the oesophagus. The importance of hiatal repair

“…Achalasia is an incurable condition and the purpose of surgery is to relieve symptoms (Le Roux and Wright, 1961;Barrett, 1964). Sufferers from the condition may never haveswallowed normally and their personal satisfaction with their condition after operation must be the only criterion of success.…”

Diffuse oesophageal spasm.

“…In the 12-year period 1954-66, 12 cases of diffuse spasm were recorded in our unit. Le Roux and Wright (1961) reported on 55 cases of aChalasia in the same unit during the 10-year period 1948-58. In our experience, achalasia, which is a rare disease, is approximately five times more common than diffuse oesophageal spasm.…”