特発性食道拡張症の運動機能面に関する臨床的研究

概要

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Ideopathic esophageal dilatation was first reported by Willis in 1672 and is atill considered as one of the very rare disease. Cause or real entity of this illness has been speculated and hypothesized by many authors but none of them has been conclusive enough to be believed. From the year of 1946 to 1962, 202 clinical cases of this illness were examined in our department and clinical investigative work was carried out on pathophysiology of this illness from the point of functional motility of the diseased esophagus and the following conclusions were obtained. (1) The longer the duration of illness, the more fluccid dilatation of the esophagus can be observed. (2) Parasymathetic dominancy innervation is noted at the lower esophagus and esophago-cardiac junction. (3) Muscles of the lower esophageal wall is fluccid. (4) Inbalance of the opening mechanism of the cardiac entrance is present. (5) Degenerative changes of the Auerbach's nervous plexus are always present. (6) Defenite changes in the sensory nerve fibers are constantly observed. As a partial or transitory changes : (7) Spasm can occur at the esophago-cardiac junction. (8) Correlation between the central nervous system is speculated. In very limited numbers of patients, following rather exceptional changes were observed. (1) High degree of dilatation was noted in spite of a rather short duration of illness. (2) Parasympathetic dominancy was not observed. (3) Fluccid paresis of the esophageal muscle failed to be observed under careful investigation. (4) Esophago-cardial portion was found to be completely normal but a stenotic changes were present at the 3rd physiological narrowing site of the esophagus. These exceptional changes, seemed to be present on those suffering from different diseases rather than the illness that the author is describing. There were some cases whose entity or cause was on congenital origin.
千葉大学の論文
1964-03-28

著者

野本昌三
千葉大学医学部第2外科学教室

特発性食道拡張症の運動機能面に関する臨床的研究

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