الفهرس | Only 14 pages are availabe for public view |
Abstract The esophagus is a small hose-like tube, which connects the mouth to the stomach. As it leaves the mouth, it follows a straight path through the neck and chest, passing near the heart through the diaphragm muscle and finally entering the stomach. The esophageal walls composed of muscles, which move in wave-like contractions to push food into the stomach. Surgery on the esophagus is always difficult because of its location within the chest and its slow rate of healing. (Foster & Smith, 2007). Difficulty swallowing liquids or solids, heartburn, regurgitation, and atypical (or non-cardiac) chest pain may be symptoms of an esophageal motility disorder. Examples of motility disorders of the esophagus gastroesophageal reflux disease (GERD), dysphagia, achalasia, and functional chest pain. (Henry , 2005). 1)Gastro esophageal reflux disease (GERD). 2)Achalasia. The cause of achalasia is unclear, although pathologically, there is loss of the ganglion cells (nerve cells) within the lining of the esophagus. 3)Esophageal rings and webs. 4)Lower esophageal ring (Schatzki). 5)Diffuse esophageal spasm. 6)Corkscrew esophagus. 7)Nutcracker esophagus. 8)Hypertensive peristalsis, hypercontracting LES, and hypertensive LES. 9)Inappropriate transient LES relaxation. 10)Hypotensive esophagus. 11)Ineffective esophageal clearance. Motor disorder of the esophagus exists once the normal organization of sphincteric contractions and relaxations has been permanently disturbed. Now that normal human esophageal motility can be precisely specified by manometer, it is possible to define the profiles of abnormal motility .Other modalities of investigation used in the context of motility disorders are: 1) ENDOSCOPY: Endoscopy is a procedure in which a flexible fiberoptic tube with a light and camera on the end is swallowed. 2) X-RAY study: Has an important role in diagnosis although it is simple investigation. 3) Esophageal manometric: Basic investigation for all esophageal motility disorders. 4) Radioactive transit(99m)Tc. 5) MRI. 6) Ph study: Gold standard for GERD. Clareo M. &Bresser A.( 2004). |