Endoscopic ultrasound in patients with esophageal achalasia

Sajewicz Z, WoĽniak-Stolarska B, Salomon A, Wa¶ko-Czopnik D, Paradowski L: Endoscopic ultrasound in patients with esophageal achalasia

Introduction: The major role in the esophageal achalasia diagnosis is played by manometry, which shows an increase of lower esophageal sphincter pressure and the absence of peristalsis in the middle esophageal region.

Aims: An assessment of usefulness of endoscopic ultrasonography in the achalasia diagnosis.

Material and methods: We examined 10 patients with achalasia and 10 persons without esophageal pathology. We measured the thickness of the muscle layer at the level of lower esophageal sphincter with the usage of Pentax FG-38UX echoendoscope of 10 MHz frequency connected with Hitachi EUB 6000 ultrasonograph.

Results: In the achalasia group the thickness of the muscularis propria amounted 0.482 ± 0.160 cm and appeared to be significantly higher than the one observed in the control group – 0.290 ± 0.122 cm (p < 0.05).

Conclusions: 1. The thickness of the muscle layer at the level of lower esophageal sphincter in patients with achalasia was significantly higher than the one observed in control group. 2. Endoscopic ultrasound is a complementary method in the diagnosis of achalasia and can contribute to the differential diagnosis of the pseudoachalasia.

Key words: endoscopic ultrasound – achalasia – muscularis propria of the esophagus.