Background: Esophageal achalasia is a primary motor disorder of the esophagus characterized by impair relaxation of the lower esophageal sphincter and absent of esophageal peristalsis. Per-oral endoscopic myotomy is an alternative treatment to surgical Heller myotomy in patients over 65 years old. The aim of this paper was to describe the results of peroral endoscopic myotomy POEM or the treatment of achalasia in geriatric patients. Methods: We included patients over 65 years old with POEM, from retrospective cohort review, in which POEM was performed with a standardized technique in our department. Conclusions: POEM is a safe and effective technique for the treatment of achalasia, the results of the study are similar to those reported in the literature.

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An update on esophageal perforation. Correspondencia a:. Esophageal perforation is a complicated clinical entity that demands a high level of diagnostic and therapeutic skills. The management alternatives vary from conservative treatment to esophagectomy, including primary suture and esophageal exclusion. This paper is a review of the literature and personal experience with this condition, focusing on etiology, clinical presentation, diagnostic workout, treatment, complications and mortality.

Key Words: Digestive system; Esophagoscopy; Esophageal perforation. Se puede categorizar como trauma cerrado o penetrante. Pacientes con perforaciones cervicales se quejan de dolor cervical, disfagia y odinofagia 2,6. Manejo no instrumental. Los criterios para el manejo conservador fueron propuestos inicialmente por Cameron en , siendo actualizados por Altorjay en 31 e incluyen:. Perforaciones intramurales. Contar con el apoyo de un cirujano especialista con experiencia en el tema.

Esta idea fue inicialmente propuesta por Grillo y Wilkins en y ratificado en por Whyte y Orringer El refuerzo del cierre primario con tejido perilesional viable es controversial. Surgical aspects of esophageal disease: perforation and caustic injury. Blom D, Peters J. Esophageal perforation. In: Cameron JL, ed. Current Surgical Therapy. St Louis, MO: Mosby, Surgery in thoracic esophageal perforation: primary repair is feasible. Dis Esophagus ; Current results of therapy for esophageal perforation.

Am J Surg ; Ann Thorac Surg ; Younes Z, Johnson DA. The spectrum of spontaneous and iatrogenic esophageal injury: perforations, Mallory-Weiss tears, and hematomas.

J Clin Gastroenterol ; Multimodality treatment of esophageal disruptions. Chest ; Diagnosis and recommended management of esophageal perforation and rupture. Jones GW, Ginsberg R. Esophageal perforation: a continuing challenge. Ruiz F et al. Rev Chil Cir ; Esophageal perforation: emphasis on management.

The diagnosis and treatment of esophageal perforations resulting from nonmalignant causes. Surg Today ; Management of esophageal perforation.

Treatment and outcomes of oesophageal perforation in a tertiary referral center. Eur J Cardio Thorac Surg ; Gupta NM, Kaman L. Personal management of 57 consecutive patients with esophageal perforation.

Treatment of endoscopic esophageal perforation. Surg Endosc ; Comparison among the perforation rates of Maloney, balloon, and Savary dilatation of esophageal strictures. Gastrointestinal Endoscopy ; Enns R, Branch M.

Management of esophageal perforation after therapeutic upper gastrointestinal endoscopy. Lemke T, Jagminas L. Spontaneous esophageal rupture: a frequently missed diagnosis.

Am Surg ; Eisen G et al. Guideline for the management of ingested foreign bodies. Mechanisms of gastric and esophageal perforations during laparoscopic Nissen fundoplication. Ann Surg ; Experience with the Grillo pleural wrap procedure in 18 patients with perforation of the thoracic esophagus.

Boerhaave's Syndrome: Primary Repair vs. J Gastrointest Surg ; 7: Management of delayed esophageal perforation with mediastinal sepsis; esophagectomy or primary repair? J Thor Cardiovasc Surg ; The role of esophagectomy in the management of esophageal perforations. Radiologic diagnosis of gastrointestinal perforation. Radiol Clin N Am ; Short and long term outcome of esophageal perforation. Omental wrapping of perforated esophagus. Nonoperative management of esophageal perforations.

Is it justified? Intrathoracic esophageal perforation. The merit of primary repair. J Thorac Cardiovasc Surg ; Successful management of a nonmalignant esophageal perforation with a coated stent.

Ann Thorac Surg. Succesful late management of spontaneous esophageal rupture using T tube mediastinoabdominal drainage. Use of large-diameter metallic stents to seal traumatic nonmalignant perforations of the esophagus. Gastrointest Endosc ; Aceptado el 28 de julio, Correspondencia a: Dr. Italo Braghetto M. Santos Dumont , Independencia. Fax: E mail: ibraghet redclinica. Servicios Personalizados Revista.

Correspondencia a: Esophageal perforation is a complicated clinical entity that demands a high level of diagnostic and therapeutic skills. Los criterios para el manejo conservador fueron propuestos inicialmente por Cameron en , siendo actualizados por Altorjay en 31 e incluyen: 1. Referencias 1.


Cómo comprender la dilatación esofágica

Aetna considers speech therapy for treatment of dysphagia, regardless of the presence of a communication disability, medically necessary for members who meet the criteria set forth below. Tenga en cuenta lo siguiente :Some plans limit coverage of medically necessary speech therapy services. Members should check their benefit plan descriptions for any applicable benefit plan limitations and exclusions on coverage for speech therapy services. Aetna considers esophageal dilation medically necessary for the treatment of symptomatic obstruction of the esophagus. Aetna considers esophageal dilation for the treatment of non-obstructive esophageal dysphagia experimental and investigational because its effectiveness has not been established.


Dysphagia Therapy

Noventa y cinco pacientes fueron incluidos en el estudio. El tiempo de seguimiento medio fue de 56 meses rango meses. Laparoscopic Heller myotomy has become the gold standard procedure for patients with achalasia. This study evaluates the clinical status, quality of life, and functional outcomes after laparoscopic Heller myotomy..


Divertículo de Zenker

Comparison between idiopathic achalasia and achalasia caused by Chagas' disease: a review about the pathophysiology of the diseases. AIMS: We performed a review of papers with results about the pathophysiology and esophageal motility alterations in idiopathic achalasia and Chagas' disease. The results of the studies of the effects of atropine, edrophonium and botulin toxin suggested that the excitatory innervation is more intensely impaired in Chagas' disease than in idiopathic achalasia, explaining the increase in the lower esophageal sphincter pressure found in achalasia. The patients with Chagas' disease have more circulating muscarinic cholinergic receptor M2 autoantibodies than patient with idiopathic achalasia. The duration of the contractions in the esophageal body is longer in idiophatic achalasia than in Chagas' disease. Headings: Esophageal achalasia.

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