Clinical and roentgenological studies on achalasia, especially in relation to the surgical lherapy

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概要

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• For the clinical examination of the achalasia, X-ray type, the largest diameter, longitudinal axis, tension of wall, motility at the esophagus, esophagitis were discussed roentgenologically in detail.Thirty cases of the conservatively treated achalasia were successively followed up roentgenologically. Among them, 10 cases (33.3%) had changes of roentgenological types, of which 7 cases changed from spindle type to flask type, 2 cases from flask type to sigmoid type, 1 case from spindle type to flask type, and further to sigmoid type, and 15 cases (50%) had enlargement of the largest diameter of esophagus, as principal roentgenological changes.As secondary roentgenological changes, 7 cases (23.3%) had changes of longitudinal axis, 15 cases (50%) had changes of tension of wall, 12 cases (40%) had changes of motility at the esophagus and 14 cases (46.7%) had worsened esophagitis.These secondary changes were observed, in general, together with the two principal changes mentioned.In examination to the duration of suffering and two principal roentgenological changes, 3 cases (37.5%) had changes of types or the largest diameter of the esophagus among 8 cases which were under 5 years of suffering, 5 cases (45.4%) had changes among 11 cases from 6 to 9 years of suffering, and 7 cases (63.6%) had changes among 11 cases over 10 years of suffering.In general, roentgenological changes were in accordance with the duration of suffering.In the meanwhile, we used various operative methods in the surgical therapy to this disease. In persuit of the results of operation on 160 cases, 139 cases (86.9%) had good or better results.In conclusion, this disease must be strictly followed up roentgenologically. In cases of finding progress of roentgenological abnormalities, surgical therapy must be applied to this disease.

• 財団法人 日本消化器病学会の論文

著者

• 下鳥 隆生

  千葉大学第2外科

• 下鳥 隆生

  千葉大学第二外科

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