Gastrointestinal: Role of endoscopic ultrasound in the evaluation of pseudoachalasia

Bryant, Robert V.; Holloway, Richard L.; Nguyen, NQ

doi:10.1111/j.1440-1746.2012.07135.x

Cited by 5 publications

(3 citation statements)

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“…Endoscopic biopsy is used for the diagnosis of secondary pseudoachalasia. [60][61][62][63][64] Recommendation: We recommend performing UGI endoscopy in adult with the suspected diagnosis of achalasia to exclude neoplastic pseudoachalasia. Good practice recommendation.…”

Section: Endoscopy Should Be Performed In Patients With Suspected Ach...mentioning

confidence: 99%

The 2018 ISDE achalasia guidelines

Zaninotto

Bennett

Boeckxstaens

et al. 2018

Diseases of the Esophagus

243

218

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Achalasia is a relatively rare primary motor esophageal disorder, characterized by absence of relaxations of the lower esophageal sphincter and of peristalsis along the esophageal body. As a result, patients typically present with dysphagia, regurgitation and occasionally chest pain, pulmonary complication and malnutrition. New diagnostic methodologies and therapeutic techniques have been recently added to the armamentarium for treating achalasia. With the aim to offer clinicians and patients an up-to-date framework for making informed decisions on the management of this disease, the International Society for Diseases of the Esophagus Guidelines proposed and endorsed the Esophageal Achalasia Guidelines (I-GOAL). The guidelines were prepared according the Appraisal of Guidelines for Research and Evaluation (AGREE-REX) tool, accredited for guideline production by NICE UK. A systematic literature search was performed and the quality of evidence and the strength of recommendations were graded according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Given the relative rarity of this disease and the paucity of high-level evidence in the literature, this process was integrated with a three-step process of anonymous voting on each statement (DELPHI). Only statements with an approval rate >80% were accepted in the guidelines. Fifty-one experts from 11 countries and 3 representatives from patient support associations participated to the preparations of the guidelines. These guidelines deal specifically with the following achalasia issues: Diagnostic workup, Definition of the disease, Severity of presentation, Medical treatment, Botulinum Toxin injection, Pneumatic dilatation, POEM, Other endoscopic treatments, Laparoscopic myotomy, Definition of recurrence, Follow up and risk of cancer, Management of end stage achalasia, Treatment options for failure, Achalasia in children, Achalasia secondary to Chagas' disease.

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Section: Endoscopy Should Be Performed In Patients With Suspected Ach...mentioning

confidence: 99%

The 2018 ISDE achalasia guidelines

Zaninotto

Bennett

Boeckxstaens

et al. 2018

Diseases of the Esophagus

243

218

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“…EUS also facilitates acquisition of a tissue sample, adding further to its utility in the diagnostic workup of patients in which pseudoachalasia is suspected. EUS represents a valuable tool in the evaluation of pseudoachalasia, particularly where clinical suspicion is high and other modalities have been unrevealing [ 29 , 30 ]. Considering the patient's age, the lack of evidence for malignancy in the clinical history, and the findings in the first endoscopy and biopsies, we argue that it may be appropriate to amend the preoperative workup for achalasia introduction of EUS among routine exams to reduce the delay in diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Achalasia Secondary to Submucosal Invasion by Poorly Differentiated Adenocarcinoma of the Cardia, Siewert II: Consideration on Preoperative Workup

Agrusa

Frazzetta

et al. 2014

Case Reports in Surgery

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Secondary achalasia due to submucosal invasion of cardia by gastric cancer is a rare condition. We report a case of pseudoachalasia, secondary to the involvement of gastroesophageal junction by poorly differentiated gastric cancer, initially mistaken as idiopathic form. We focus on the difficulty to establish differential diagnosis only on the basis of routine exams and we stress the necessity of “second level” instrumental exams; EUS in routine workup in selected patients should be considered. We support that routine workup based on history, clinical presentation, radiological and endoscopic findings, and certainly manometry could be insufficient for a correct differential diagnosis between primary and secondary forms in some patients.

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“…The short duration of efficacy of recurrent esophageal dilatation as well as the failure of effacement of the GEJ upon pneumatic dilatation should raise suspicion of pseudoachalasia. Endoscopic ultrasound (EUS) may be key to the diagnostic success, given its high image resolution with close proximity to the lesion, and it facilitates acquisition of a tissue sample, adding further to its utility in the diagnostic work‐up of patients where pseudoachalasia is suspected …”

Section: Achalasia and Pseudoachalasia Esophagus: What Is The Relatiomentioning

confidence: 99%

Benign and precursor lesions in the esophagus

Akiyama

Bertelè²,

Brock

et al. 2014

Annals of the New York Academy of Sciences

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The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on the role of salivary stimulation and esophageal secretion of protective factors in prevention of adenocarcinoma sequelae in gastroesophageal reflux disease; the pediatric conditions associated with esophageal cancer; the relationship of achalasia and pseudoachalasia with esophageal cancer; the potential for malignant transformation in eosinophilic esophagitis and overlap syndromes; the role of lymphocytic esophagitis as an overlapping phenotype; the role of Barrett's esophagus as a premalignant condition; the indications and type of treatment of premalignant conditions of the esophagus; and the decision for use of endoscopical procedures in premalignant conditions of the esophagus.

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Gastrointestinal: Role of endoscopic ultrasound in the evaluation of pseudoachalasia

Cited by 5 publications

References 0 publications

The 2018 ISDE achalasia guidelines

The 2018 ISDE achalasia guidelines

Achalasia Secondary to Submucosal Invasion by Poorly Differentiated Adenocarcinoma of the Cardia, Siewert II: Consideration on Preoperative Workup

Benign and precursor lesions in the esophagus

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