ACHALASIA CARDIA

ACHALASIA CARDIA


  • It is a failure of smooth muscle fibers to relax, which can cause the lower esophageal sphincter(LES) to remain closed.
  • It is esophageal motility disorder.
  • pathology - selective absence of inhibitory neurons and there is absence of LES relaxations. only Auerbach plexus is present and Meisner's plexus is absent.
 clinical features:

  1. most common symptom - Dysphagia > weight loss (dysphagia is more to liquids than solid)
  2. Risk of Aspiration - Pneumonitis, that leads to lung abscess
  3. increase risk of squamous cell carcinoma (scc)


IOC - Barium swallow - BIRD BEAK / RAT TAIL / PENCIL TIP APPEARANCE



TREATMENT : 

   TOC - Laproscopic Heller's cardiomyotomy
            - partial fundoplication - DOR / TOUPET fundoplication done
            - POEM - per oral endoscopic myotomy 




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