Esophagogastric junction outflow obstruction

被引:43
作者
Bredenoord, Albert J. [1 ]
Babaei, Arash [2 ]
Carlson, Dustin [3 ]
Omari, Taher [4 ]
Akiyama, Jun [5 ]
Yadlapati, Rena [6 ]
Pandolfino, John E. [3 ]
Richter, Joel [7 ]
Fass, Ronnie [8 ]
机构
[1] Amsterdam Univ Med Ctr, Dept Gastroenterol, Amsterdam, Netherlands
[2] Natl Jewish Hlth, Dept Med, Div Gastroenterol, Denver, CO USA
[3] Northwestern Univ, Dept Med, Feinberg Sch Med, Div Gastroenterol & Hepatol, Chicago, IL 60611 USA
[4] Flinders Univ S Australia, Coll Med & Publ Hlth, Adelaide, SA, Australia
[5] Natl Ctr Global Hlth & Med, Div Gastroenterol & Hepatol, Tokyo, Japan
[6] Univ Calif San Diego, Ctr Esophageal Dis, Div Gastroenterol & Hepatol, La Jolla, CA 92093 USA
[7] Univ S Florida, Coll Med, Joy McCann Culverhouse Ctr Esophageal Dis, Tampa, FL 33620 USA
[8] Case Western Reserve Univ, Metrohlth Med Syst, Div Gastroenterol & Hepatol, Esophageal & Swallowing Ctr, Cleveland, OH 44106 USA
关键词
achalasia; dysphagia; high-resolution manometry; outflow obstruction; HIGH-RESOLUTION MANOMETRY; LOWER ESOPHAGEAL SPHINCTER; PRESSURE TOPOGRAPHY METRICS; INTRALUMINAL IMPEDANCE; CHICAGO CLASSIFICATION; MOTILITY DISORDERS; NORMAL VALUES; ACHALASIA; SUPINE; DETERMINANTS;
D O I
10.1111/nmo.14193
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
In the Chicago Classification version 4.0 (CCv4), esophagogastric junction outflow obstruction (EGJOO) is manometrically defined as an elevated median integrated relaxation pressure (IRP) and elevated intrabolus pressure (IBP) during supine wet swallows, and persistently elevated median IRP in the upright position. A clinically relevant conclusive diagnosis of EGJOO requires a manometric diagnosis of EGJOO and associated symptoms such as dysphagia and/or chest pain with at least one of the following supportive investigations (pharmacologic provocation, timed barium esophagogram, and/or endoflip). The Chicago Classification is intended for diagnosis of primary esophageal motor disorders, and thus history and endoscopic evaluation are important to exclude conditions (eg, previous surgery, strictures, or masses) that can secondarily generate the EGJOO pattern on HRM. While a manometric finding of EGJOO is often made and can be an early sign of achalasia, more often it is a manometric finding without clinical implications. The proposed changes in CC4.0 have attempted to make the diagnosis more specific, in order to reduce the number of clinically irrelevant diagnoses and avoid confusion by patients and physicians alike.
引用
收藏
页数:13
相关论文
共 68 条
[1]   Rapid Drink Challenge in high-resolution manometry: an adjunctive test for detection of esophageal motility disorders [J].
Ang, D. ;
Hollenstein, M. ;
Misselwitz, B. ;
Knowles, K. ;
Wright, J. ;
Tucker, E. ;
Sweis, R. ;
Fox, M. .
NEUROGASTROENTEROLOGY AND MOTILITY, 2017, 29 (01)
[2]   EFFECT OF TIME INTERVAL BETWEEN SWALLOWS ON ESOPHAGEAL PERISTALSIS [J].
ASK, P ;
TIBBLING, L .
AMERICAN JOURNAL OF PHYSIOLOGY, 1980, 238 (06) :G485-G490
[3]   Pressure exposure and catheter impingement affect the recorded pressure in the Manoscan 360 system [J].
Babaei, A. ;
Szabo, A. ;
Yorio, S. D. ;
Massey, B. T. .
NEUROGASTROENTEROLOGY AND MOTILITY, 2018, 30 (08)
[4]   Determinants of pressure drift in Manoscan™ esophageal high-resolution manometry system [J].
Babaei, A. ;
Lin, E. C. ;
Szabo, A. ;
Massey, B. T. .
NEUROGASTROENTEROLOGY AND MOTILITY, 2015, 27 (02) :277-284
[5]   Cardiovascular compression of the esophagus and spread of gastro-esophageal reflux [J].
Babaei, A. ;
Mittal, R. K. .
NEUROGASTROENTEROLOGY AND MOTILITY, 2011, 23 (01) :45-E3
[6]   Pharmacologic interrogation of patients with esophagogastric junction outflow obstruction using amyl nitrite [J].
Babaei, Arash ;
Shad, Sadaf ;
Szabo, Aniko ;
Massey, Benson T. .
NEUROGASTROENTEROLOGY AND MOTILITY, 2019, 31 (09)
[7]   Chronic daily opioid exposure is associated with dysphagia, esophageal outflow obstruction, and disordered peristalsis [J].
Babaei, Arash ;
Szabo, Aniko ;
Shad, Sadaf ;
Massey, Benson T. .
NEUROGASTROENTEROLOGY AND MOTILITY, 2019, 31 (07)
[8]   Low Yield of Cross-Sectional Imaging in Patients With Esophagogastric Junction Outflow Obstruction [J].
Beveridge, Claire A. ;
Falk, Gary W. ;
Ahuja, Nitin K. ;
Yang, Yu-Xiao ;
Metz, David C. ;
Lynch, Kristle L. .
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2020, 18 (07) :1643-1644
[9]   Rapid drink challenge test during esophageal high resolution manometry in patients with esophago-gastric junction outflow obstruction [J].
Biasutto, D. ;
Mion, F. ;
Garros, A. ;
Roman, S. .
NEUROGASTROENTEROLOGY AND MOTILITY, 2018, 30 (06)
[10]   Upper esophageal sphincter (UES) metrics on high-resolution manometry (HRM) differentiate achalasia subtypes [J].
Blais, P. ;
Patel, A. ;
Sayuk, G. S. ;
Gyawali, C. P. .
NEUROGASTROENTEROLOGY AND MOTILITY, 2017, 29 (12)