Diffuse esophageal spasm: radiographic and manometric correlation.

Chen, Y M; Ott, David J.; Hewson, Edward G.; Richter, J. E.; Wu, Wallace C.; Gelfand, DW; Do, Castell

doi:10.1148/radiology.170.3.2916033

Cited by 49 publications

(26 citation statements)

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“…Isobaric m a n o m e t r i c pressure signatures measured within a nearly static bolus in the esophagus are c o m m o n l y observed in esophageal motility disorders such as diffuse esophageal spasm (DES) and achalasia, wherein peristalsis is either entirely absent, or absent for intervals of time. Typically, DES occurs in the lower esophagus as a nonspecific series of muscle contractions acting on a static bolus interspersed with n o r m a l peristaltic contractions [ 19]. Other nonspecific m o t o r disorders have been observed in which a r a n d o m sequence of m a n o m e t r i c pressure waves occurs along with a traveling peristaltic wave [20].…”

Section: Manometric Pressure In a Nearly Static Bolus: Absence Of Permentioning

confidence: 99%

“…Other nonspecific m o t o r disorders have been observed in which a r a n d o m sequence of m a n o m e t r i c pressure waves occurs along with a traveling peristaltic wave [20]. Chen et al [19] point out the difficulties encountered in attempting to diagnose DES manometrically or radiographically, in the absence of the other method.…”

Section: Manometric Pressure In a Nearly Static Bolus: Absence Of Permentioning

confidence: 99%

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Interpretation of intraluminal manometric measurements in terms of swallowing mechanics

1991

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A unified discussion of the mechanics of the swallowing process, and its interpretation through manometric measurements of intraluminal pressure, are presented in this paper. The goals of the discussions are to provide the reader with basic knowledge of pharyngeal, esophageal, and sphincter mechanics; to relate the mechanical processes to intraluminal pressure recordings; and to clarify the relationship between intraluminal pressure and esophageal muscle contractile behavior. The esophageal phase of bolus transport, in particular, is discussed in some detail due to the relatively simple geometry and the straightforward description of peristalsis and muscle mechanics in this region. Several important issues are emphasized in the discussion. For example, pressure variation within a static bolus is fundamentally different from that within a moving bolus. Manometric recordings must be interpreted accordingly. The importance of differentiating between "hydrodynamic pressure," which is pressure measured within a fluid bolus, and "contact pressure," which is the direct squeeze of the luminal wall on the manometric port in a region devoid of bolus fluid, is discussed in some detail. We argue that pressure "amplitude" does not, in principle, give any indication of the forces required to drive the fluid bolus forward. What should be sought is the variation of intrabolus pressure relative to the contact pressure, particularly during periods in which the contractile segment fails to obliterate the esophageal lumen. Examples of intraluminal pressure recording in the esophagus, using manometry and mathematical models, are presented to demonstrate both the possibilities and the difficulties of interpreting manometric recordings in the absence of concurrent radiographic imaging. We discover that in regions of nearly complete luminal closure, the pressure signature and bolus geometry are strongly coupled during peristaltic transport, providing the possibility that in these regions quantitative measures of muscle performance might be developed without the need for radiographic imaging. On the other hand, the ambiguity in the interpretation of manometric recordings that often accompanies dysphagic conditions suggests that as more sophisticated interpretations are sought, manometry concurrent with radiography will play a more prominent role in patient evaluation.

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Section: Manometric Pressure In a Nearly Static Bolus: Absence Of Permentioning

confidence: 99%

Section: Manometric Pressure In a Nearly Static Bolus: Absence Of Permentioning

confidence: 99%

Interpretation of intraluminal manometric measurements in terms of swallowing mechanics

1991

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“…Symptomatic diffuse esophageal spasm may manifest on barium studies as intermittently weakened or absent primary peristalsis with repetitive, lumen-obliterating, nonperistaltic contractions that produce a classic "corkscrew" esophagus (76). More commonly, however, these patients have multiple nonperistaltic contractions of mild to moderate severity without a corkscrew esophagus (77).…”

Section: Other Esophageal Motility Disordersmentioning

confidence: 99%

Diseases of the Esophagus: Diagnosis with Esophagography

Levine

Rubesin²

2005

Radiology

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The barium esophagram is a valuable diagnostic test for evaluating structural and functional abnormalities of the esophagus. The study is usually performed as a multiphasic examination that includes upright double-contrast views with a high-density barium suspension, prone single-contrast views with a low-density barium suspension, and, not infrequently, mucosal-relief views with either density of barium suspension. The double-contrast phase optimizes the ability to detect inflammatory or neoplastic diseases, whereas the single-contrast phase optimizes the ability to detect hiatal hernias and lower esophageal rings or strictures. Fluoroscopic examination of the esophagus is also important for assessing motility disorders such as achalasia and diffuse esophageal spasm. This article is a review of gastroesophageal reflux disease, other types of esophagitis, benign and malignant esophageal tumors, varices, lower esophageal rings, diverticula, and esophageal motility disorders, all of which can be diagnosed with the aid of esophagography.

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“…Diffuse esophageal spasm is an uncommon motility disorder [42,43]. Patients show intermittently abnormal peristalsis with simultaneous contractions, and usually have normal lower esophageal sphincter function.…”

Section: Esophageal Motility Disordersmentioning

confidence: 99%

Radiographic techniques and efficacy in evaluating esophageal dysphagia

Ott

1990

Dysphagia

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The radiographic examination of the esophagus to determine structural and/or functional causes of dysphagia is best performed with multiple techniques. These include full-column studies to produce distended films with or without the use of a solid bolus, mucosal relief films to identify mucosal defects such as esophagitis or the presence of varices, double-contrast films, and motion recording (fluoroscopy). The efficacy of each technique depends on the quality of the study and the specific disorder to be detected. Esophageal lesions producing dysphagia are classified into extrinsic structural lesions, intrinsic structural lesions, and esophageal motility disorders. Radiographic studies are the preferred screening techniques for patients with dysphagia. Although not as sensitive for the evaluation of mucosal lesions, radiographic studies are superior to endoscopy for the detection of abnormal motility, esophageal rings, and strictures.

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Diffuse esophageal spasm: radiographic and manometric correlation.

Cited by 49 publications

References 0 publications

Interpretation of intraluminal manometric measurements in terms of swallowing mechanics

Interpretation of intraluminal manometric measurements in terms of swallowing mechanics

Diseases of the Esophagus: Diagnosis with Esophagography

Radiographic techniques and efficacy in evaluating esophageal dysphagia

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