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Irreversible esophageal motor dysfunction in postvagotomy dysphagia
The American Journal of Gastroenterology
|October 1, 1981
Summary
Postvagotomy dysphagia can lead to irreversible esophageal motility disorders. Two patients experienced persistent symptoms, with one improving after pneumatic dilation, suggesting a potential secondary achalasia.
Area of Science:
- Gastroenterology
- Esophageal Motility Disorders
- Surgical Complications
Background:
- Postvagotomy dysphagia is usually transient.
- A subset of patients develops persistent esophageal dysfunction.
- Vagotomy can impact esophageal motility.
Observation:
- Two patients presented with persistent symptomatic esophageal dysfunction post-vagotomy.
- Both patients experienced rapid initial weight loss followed by stabilization.
- Esophageal manometry revealed aperistalsis and diminished motor activity.
Findings:
- Distal esophageal dilation was observed in both patients.
- One patient had normal lower esophageal sphincter pressure despite aperistalsis.
- Esophageal abnormalities were refractory to mercury bougie dilation.
- Pneumatic dilation improved symptoms in one patient.
Implications:
- This suggests a potential nonneoplastic secondary achalasia as a cause.
- Persistent esophageal dysfunction requires further investigation beyond temporary dysphagia.
- Pneumatic dilation may be a therapeutic option for refractory cases.