Esophagography in Patients With Esophageal Achalasia Diagnosed With High-resolution Esophageal Manometry

( Takahisa Yamasaki ),( Toshihiko Tomita ),( Sumire Mori ),( Mayu Takimoto ),( Akio Tamura ),( Ken Hara ),( Takashi Kondo ),( Tomoaki Kono ),( Katsuyuki Tozawa ),( Yoshio Ohda ),( Tadayuki Oshima ),( 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2018 Journal of Neurogastroenterology and Motility (JNM Vol.24 No.3

Background/Aims High-resolution esophageal manometry (HREM) is considered to be the gold standard for the diagnosis of achalasia. However, the Japan Esophageal Society recommends that esophagography is also accurate in either diagnosing or excluding the disorder. Accordingly, we compared the efficacy of esophagography and HREM in diagnosing achalasia patients with upper gastrointestinal symptoms. Methods HREM was performed in 126 patients with dysphagia. The final diagnosis of achalasia was done using HREM. Demographic data, symptoms, quality of life (QOL) were also obtained. We assessed the patients who were not able to be diagnosed by esophagography and compared the diagnostic values for esophagography with HREM-based achalasia diagnosis as the gold standard. Results A total of 48 cases of patients with achalasia, including 21 men and 27 women (mean age, 48.4 ± 19.6 years), were included in the study. Two patients were excluded. Of the remaining 46 patients, 36 (78.3%) patients were diagnosed as having achalasia by esophagography. The diagnostic sensitivity, specificity, and accuracy of esophagography were 78.3%, 88.0%, and 83.0%, respectively. Patients with type III achalasia had significantly lower physical QOL score than those with type I or II achalasia. Although the mental QOL score in patients with type III achalasia tended to decrease compared with that in patients with type I and II achalasia, the difference was not statistically significant. Conclusions Diagnosing esophageal achalasia by using esophagography alone has limited yield. Therefore, HREM should be used in patients with dysphagia and in whom achalasia cannot be diagnosed using EGD or esophagography. (J Neurogastroenterol Motil 2018;24:403-409)

A NEW DOUBLE CONTRAST ESOPHAGOGRAPHY

Lee, Sung Woo 인제대학교 1981 仁濟醫學 Vol.2 No.3

종래의 식도 검사법은 작고 미묘한 병면을 놓치는 일이 많아 여러 사람들이 새로운 식도 X선 이중조영법을 시도해 왔다. 저자는 새로운 이중 조영법을 개발하고 의사의 지시대로 설수 있는 5∼81세의 환자 537명에게 적용하였다. 이 방법은 Barium 한 모금과 공기를 같이 마시는 간편하고, 시간이 절약되며 또 누구나 쉽게 行할 수 있는 방법으로 타 소화기관에도 적용되는 이중조영법의 이점이외에 식도의 운동상태를 파악하는 장점이 있다. A minute and subtle lesion of the esophagus could be easily missed by conventional esophagography. Many attempts of double contrast esophagography have been made without content in the past. The author developed a new double contrast esophagography and applied it to the total 537 cases ranging from 5 to 81 years of age, who could stand and do as a fluoroscopist desired. A new method of a double contrast esophagogram which only needs a single bolus intake of barium and air is simple, time-saving and easily applicable. This method is also good for the evaluation of the esophageal motility, besides the many advantages of the double contrast study of the esophageal lesion.

Congenital bronchoesophageal fistula in an adult: a case report and radiologic review

강은주,김보성,이기남,최필조 고신대학교(의대) 고신대학교 의과대학 학술지 2018 고신대학교 의과대학 학술지 Vol.33 No.3

Congenital bronchoesophageal fistula (BEF) is rarely reported in adults in the English literature. Herein, we present a rare case of congenital BEF in a 43-year-old man that was incidentally found on esophagogastroduodenoscopy. Chest CT and barium esophagography revealed a fistula between his lower esophagus and the right lower lobe segmental bronchus. After the fistula was surgically treated, the fistula was no longer noted on follow-up barium esophagography.

Marshmallow를 이용한 식도조영술의 의의

서정건(Jung Kun Seo),박효진(Hyo Jin Park),김경철(Kyung Chul Kim),이귀순(Kwi Soon Lee),윤상욱(Sang Wook Yoon),전재윤(Chae Yoon Chon),김기황(Ki Whang Kim),박인서(In Suh Park) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.3

N/A Background/Aims: In the evaluation of esophageal symptoms, the endoscopy, conventional esophagography using liquid barium and esophageal manometry have been used for the detection of organic and functional esophageal diseases. But some questions were raised that these studies were not capable of reproducing the esophageal symptoms and the manometry was often not a confirmative test in all functional esophageal diseases. So, we performed an esophagography using the semisolid material, marshmallow, and evaluated its clinical usefulness in patients with func- tional esophageal diseases. Methods: We perfonned the endoscopy, conventional esophagography and marshmallow esophagography in 54 consecutive patients with esophageal symptoms(dysphagia, globus symptom and non-cardiac chest pain) and esophageal manometry in 21 patients among them, and compared with asymptomatic, healthy volunteers(n=9). Results: The marshmallow esophagography revealed abnormal hesitation and impaction in 15 patients(45%) with normal conventional esophagography(n=33) and in 4 patients(57%) with normal esophageal manometry studies(n=7). In contrast with these result, all of the conventional esophagography were normal in patients with normal marshmallow esophagography(n=17). In the reproducibility of symptoms, the dysphagia group was greater than another groups(p(0.05) and there was a trend towards a high reproducibility of symptoms in patients who showed the severe grade(p (0.05). The abnormal marshmallow esophagography was correlated with the abnormal peristalsis of conventional esopha- gography and nonspecific esophageal motility disorder of manometry(p(0.05). Conclusions: We found the marshmallow esophagography was rnore sensitive and capable of reproducing the sypmtoms than conventional liquid barium esophagography in the evaluation of the esophageal symptoms, and the marshmallow esophagography is thought to be valuable as one of diagnostic tools for esophageal motility disorders. (Korean J Gastroenterol 1996; 28:303-310)

투시 조영 검사 시 환자 선량 관리를 위한 진단참고선량 구축에 관한 연구 (UGI, Esophagography 기준)

홍선숙,박은성,조준영,성민숙,양한준,Hong, Sun-Suk,Park, Eun-Seong,Cho, Joon-Yeong,Seong, Min-Suk,Yang, Han-Joon 대한디지털의료영상학회 2012 대한디지털의료영상학회논문지 Vol.14 No.1

This round of tests in patients with UGI and Esophagography data collected by national and international reference levels based on the original set of guidelines and fluoroscopy, through the provision of medical radiation exposure reduction and further optimization of Defense to realize that is intended. 359 names in our hospital underwent Esophagography 302 patients who underwent UGI average fluoroscopy time and number of images to calculate the average 21 cm Acryl phantom dose for 10 seconds and 20 seconds, average area dose and the area dose of 1 spot image, 5 spot consecutive images by measuring the patient dose and third quartile of the mean area dose was set seonryangin reference dose. Esophagography average patient dose was set to 30.05 $Gy{\cdot}cm^2$, DRL was set at a 25.37 $Gy{\cdot}cm^2$. Average dose of UGI patients were selected as 45.33 $Gy{\cdot}cm^2$, DRL was set at a 34 $Gy{\cdot}cm^2$. UGI patients with established average dose recommended in the 2008 national recommendation from the UGI examination with a dose of less than 49.7 $Gy{\cdot}cm^2$ seonryangin is evaluated. This Note examines the dose of self-aware through education recognizes the importance of dose reduction and examine if their efforts and further reduce patient dose could achieve optimization of the medical exposure is considered.

새로운 食道二重造影術

이성우,한창열 인제대학교 1980 仁濟醫學 Vol.1 No.1

새로운 食道 二重造影法이 개발됐고 그 方法을 本稿에서 소개하며 실제로 1979년 2월 1일부터 同年 8월 14일까지 537명에게 적용하여 보았다. 發見된 症例中 代表的인 것을 소개하며 이 새로움 方法은 간편하고 쉽게 시행할 수 있고 病의 早期 診斷, 早期 治療에 이바지할 것으로 믿는다. A new double contrast esphagograpy is developed and a practical application is done on 537 persons since February 1, 1979 until August 14, 1979. And representative cases are presented with the review of articles on double contrast esophagography, and this new double contrast esophagography is simple, easy to be performed and excellent to be seen through what is in the esophagus.

호두까기 식도와 비효과적 식도 운동 환자에서 Marshmallow 식도조영술의 의의

이상인 ( Sang In Lee ),이상배 ( Sang Bae Lee ),박효진 ( Hyo Jin Park ),김영균 ( Young Gyun Kim ),최성우 ( Sung Woo Choi ),조민호 ( Min Ho Cho ) 대한소화기기능성질환·운동학회 2005 Journal of Neurogastroenterology and Motility (JNM Vol.11 No.1

목적: 식도 내압 검사에서 과소수축을 보이는 비효과적 식도 운동과 과도수축을 보이는 호두까기 식도로 진단된 환자에서 marshmallow 식도조영술의 이상 유무를 평가하고 증상 및 식도 내압소견을 비교해 보았다. 대상 및 방법: 흉통, 인두종괴감, 또는 연하곤란 등의 식도관련 증상으로 시행한 식도 내압 검사에서 비효과적 식도 운동으로 진단된 23명, 호두까기 식도 36명, 식도 증상이 없는 건강 자원자군 9명, 식도증상이 있지만 정상 내압군인 37명을 Background/Aims: Ineffective esophageal motility (IEM) and a nutcracker esophagus can lead to hypocontractile dysmotility and hypercontractile dysmotility, respectively. We evaluated patients for the abnormalities of marshmallow esophagography and we comp

Respiratory Arrest Induced by Presbyesophagus: A Case Report

Yong Sung Jeong,InHyuk Suh,Jong Keun Kim,Jin Seok Bae,임종엽 대한연하장애학회 2021 대한연하장애학회지 Vol.11 No.1

Presbyesophagus is a unique cause of dysphagia in the elderly, which features incomplete relaxation of the lower esophageal sphincter, dilatation of the esophagus, decreased esophageal peristaltic pressures, abnormal esophageal contractions, and delayed emptying of the esophagus. An 88-year-old woman underwent surgery for a femur fracture. The day after surgery, respiratory arrest occurred during a meal. Breathing resumed after oxygen supply with airway opening. She complained of dysphagia and nausea during a meal, and the videofluoroscopic swallowing study and esophagography showed delayed emptying of the esophagus, abnormal esophageal contraction, and dilatation of the esophagus. This case shows that esophageal dysfunction in the elderly with poor general medical conditions can worsen abruptly.

식도확장이 뚜렷하지 않은 아칼라지아

추교영,최명규,박성규,이성희,최황,박수현,한준열,김재광,한석원,정인식,정규원,선희식 대한소화관운동학회 1999 Journal of Neurogastroenterology and Motility (JNM Vol.5 No.2

식도이완불능증의 풍선확장술 치료 전, 후의 임상 증상과 영상 소견 간의 상관 관계

문종태 ( Jong Tae Moon ),정인수 ( In Su Jung ),김영신 ( Young Shin Kim ),조승현 ( Seung Hyun Cho ),박효진 ( Hyo Jin Park ),이상인 ( Sang In Lee ) 대한소화기학회 2008 대한소화기학회지 Vol.52 No.1

Background/Aims: We investigated the risk factors for short-term recurrence and analyzed the correlation between subjective clinical symtoms and objective radiological findings in patients with achalasia undergoing pneumatic balloon dilatation. Methods: Twenty patients who were treated by pneumatic balloon dilatation were enrolled. We compared prospectively various indices before and after the treatment as follows: 1) Eckardt symptom score and dysphagia grade, 2) The ratio of the maximal width in mid-esophageal lumen to the minimal width in distal esophagus around lower esophageal sphincter, and 3) the percentage of maximum activity retained in the esophagus at 30 seconds and T½ in esophageal scan two days after the treatment. Results: 1) Clinical indices and radiologic indices significantly improved after pneumatic dilatation. 2) There was no significant correlation between the clinical indices and the radiologic indices before and after the treatment. 3) The difference percentage of clinical indices did not show significant correlation with the difference percentage of the radiologic indices. 4) Compared to the group above 20% in the difference percentage of 30 second residual fraction, the one below 20% had a four-fold risk in short-term recurrence. Conclusions: Clinical symptoms and radiologic indices significantly improve after pneumatic dilatation but have no significant correlation to each other. The group below 20% in the difference percentage of 30 second residual fraction has a high risk of recurrence and may need careful examination and early repeated pneumatic dilation. (Korean J Gastroenterol 2008;52:16-20)