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Updated: Aug 16, 2026

Use of the Scissor-Type Knife During the Peroral Endoscopy Myotomy Procedure for the Treatment of Achalasia
Published on: March 3, 2023
Endosonographic evaluation of the patient with achalasia
1Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Abstract:
Using endosonography, esophageal wall thickening is commonly observed in patients with achalasia. Imaging artifacts with the endosonographic appearance of an esophageal tumor in some patients with achalasia suggest that endosonographic images must be interpreted with caution. The endosonographer must be aware of anatomical peculiarities (dilated, tortuous, or "sigmoid" esophagus) and imaging techniques (tangential imaging) that may lead to artifactual imaging, and thereby avoid misinterpretation of results. Failure to recognize such imaging artifacts may lead to an erroneous diagnosis of pseudoachalasia, thereby subjecting patients to unnecessary surgery. Future applications of endoscopic ultrasonography for patients with achalasia may include endosonographically guided therapy. Prospective analyses of EUS-guided therapy are anticipated.
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