■臨床医のために
食道運動障害の診断
岩切 勝彦, 川見 典之, 梅澤 まり子, 佐野 弘仁, 田中 由理子, 琴寄 誠, 星原 芳雄, 坂本 長逸
日本医科大学大学院医学研究科病態制御腫瘍内科学
Achalasia and Nonachalasia Esophageal Motility Disorders
Katsuhiko Iwakiri, Noriyuki Kawami, Mariko Umezawa, Hirohito Sano, Yuriko Tanaka, Makoto Kotoyori, Yoshio Hoshihara and Choitsu Sakamoto
Department of Pathophysiological Management/Medical Oncology, Graduate School of Medicine, Nippon Medical School
Dysphagia and chest pain often occur in adults, and most patients with persistent symptoms initially undergo evaluation to rule out reflux esophagitis, esophageal cancer, and cardiovascular disease. When the findings of these evaluations are normal, esophageal manometry is performed. Esophageal motility disorders, which include achalasia, diffuse esophageal spasm, nutcracker esophagus, hypertensive lower esophageal sphincter, and nonspecific esophageal motility disorder, are often identified in these patients. In our series, 78% of patients with nonobstructive dysphagia or unexplained (noncardiac) chest pain or both have an esophageal motility disorder (achalasia, 44%; diffuse esophageal spasm, 5%; nutcracker esophagus, 2%; and nonspecific esophageal motility disorder, 27%). Therefore, in patients who present with dysphagia or chest pain or both, an esophageal motility disorder should be suspected.
日医大医会誌 2009; 5(4), 202-206
Key words
achalasia, esophageal motility disorder, esophageal manometry
Correspondence to
Katsuhiko Iwakiri, Department of Pathophysiological Management/Medical Oncology, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku Tokyo 113-8603, Japan
E-mail：k-iwa@nms.ac.jp
受付：2009年5月21日 受理：2009年6月23日 |
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