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Achalasia

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

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  1. Achalasia Prof. Dr. Faisal Ghani Siddiqui

  2. Preamble • Introduction • Pathogenesis • Clinical findings • Investigations • Differential diagnosis • Complications • Treatment

  3. Oesophageal Peristaltic Waves • Primary • Secondary • Tertiary

  4. Oesophageal Motility Disorders Primary • Unknown causes Secondary • Manifestations of systemic diseases

  5. Oesophageal Motility Disorders Primary • Achalasia • Oesophageal spasm • Nutcracker oesophagus • Hypertensive LES Secondary • Diabetes mellitus • Scleroderma • Alcohol • Psychiatric illnesses

  6. Pathogenesis

  7. Achalasia -aetiology

  8. Clinical Findings • Dysphagia • Regurgitation • Heartburn • Chest pain

  9. Dilated proximal Oesophagus Distal Oesophageal narrowing (bird’s beak)

  10. Oesophageal Manometry • Absence of oesophageal peristalsis • Partial or no relaxation of LES

  11. Differential Diagnosis • Benign strictures • Oesophageal carcinoma

  12. Complications • Aspiration | pneumonia • Chronic irritation | carcinoma oesophagus

  13. Treatment • Medical treatment • Endoscopic treatment • Surgical treatment

  14. Intersphincteric Injection of Botulinum Toxin

  15. Pneumatic Dilatation

  16. Heller Myotomy

  17. … in summary • Primary motility disorder • Absence of primary peristaltic waves & hyperactive LES • Dysphagia • Manometry diagnostic • Pneumatic dilatation | Heller myotomy

  18. ?

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