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Achalasia. Prof. Dr. Faisal Ghani Siddiqui . Preamble. I ntroduction Pathogenesis Clinical findings Investigations Differential diagnosis Complications Treatment. Oesophageal Peristaltic Waves. Primary Secondary Tertiary. Oesophageal Motility Disorders . Primary Unknown causes
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Achalasia Prof. Dr. Faisal Ghani Siddiqui
Preamble • Introduction • Pathogenesis • Clinical findings • Investigations • Differential diagnosis • Complications • Treatment
Oesophageal Peristaltic Waves • Primary • Secondary • Tertiary
Oesophageal Motility Disorders Primary • Unknown causes Secondary • Manifestations of systemic diseases
Oesophageal Motility Disorders Primary • Achalasia • Oesophageal spasm • Nutcracker oesophagus • Hypertensive LES Secondary • Diabetes mellitus • Scleroderma • Alcohol • Psychiatric illnesses
Clinical Findings • Dysphagia • Regurgitation • Heartburn • Chest pain
Dilated proximal Oesophagus Distal Oesophageal narrowing (bird’s beak)
Oesophageal Manometry • Absence of oesophageal peristalsis • Partial or no relaxation of LES
Differential Diagnosis • Benign strictures • Oesophageal carcinoma
Complications • Aspiration | pneumonia • Chronic irritation | carcinoma oesophagus
Treatment • Medical treatment • Endoscopic treatment • Surgical treatment
… in summary • Primary motility disorder • Absence of primary peristaltic waves & hyperactive LES • Dysphagia • Manometry diagnostic • Pneumatic dilatation | Heller myotomy