What is pseudoachalasia? How is it diagnosed? Pseudoachalasia, or secondary achalasia, is an esophageal motility disorder caused by a distal esophageal obstruction from an infiltrating tumor that may directly intrinsically or extrinsically compress the esophagus Patients exhibit symptoms typical of achalasia, including dysphagia, regurgitation, chest pain, and weight loss. Conventional manometry, endoscopy, and radiologic examination …
What are the basic components of laparoscopic Heller myotomy for achalasia? Surgical treatment of achalasia consists of a longitudinal myotomy of the distal esophagus and gastroesophageal (GE) junction, first described by Ernest Heller in 1913. Most myotomies were performed through the chest before the advent of minimally invasive surgery. The transabdominal laparoscopic approach is currently …
What is vigorous achalasia? Vigorous achalasia is a variant of achalasia in which the esophageal body responds to a swallow with normal or less often high-amplitude contractions that may be multiphasic, but as with classic achalasia, there are no progressive peristaltic waves. Patients with vigorous achalasia are usually younger and have chest pain as a …
Risk of gastric stump cancer after partial gastrectomy for duodenal and gastric ulcer Gastric stump carcinoma is defined as adenocarcinoma of the stomach that occurs at least 5 years after partial gastric resection for benign disease. In patients who have had a partial distal gastrectomy for gastric ulcer, the relative risk is no different than in …
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operative scheme for exploration, localization, and removal of gastrinoma If no tumor is obvious on preoperative CT scan, and other preoperative localization studies have failed, exploration begins with exposure of the anterior surface of the pancreas by mobilization of the transverse colon. A Kocher maneuver is then performed to mobilize the duodenum, allowing complete bimanual …
Where is the gastrinoma triangle? What percentage of tumors occur in this area? The apex of the gastrinoma triangle is at the cystic duct–common bile duct junction, and the triangle is bounded by the border of the second and third portions of the duodenum and the junction of the neck and body of the pancreas …
Preoperative evaluation for gastrinoma CT scan with intravenous and oral contrast is routine in the preoperative evaluation for gastrinoma resection to rule out metastatic disease, and its accuracy depends on the size of the gastrinoma. In some cases, magnetic resonance imaging (MRI) is used because it is more sensitive than CT scan for liver metastases. …