Netter's Internal Medicine 2nd Ed 11

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Ryan D. Madanick • Nicholas J.

Shaheen 61
:
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,
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. / .
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,
(transfer dysphagia), .

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(peptic esophageal
(cervical dysphagia), stricture). ,
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,
( 61-1). .

. ,
( ) .
, ,
. Schatzki ( . 61-3).
, o , 61-1,
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( . 61-1), Schatzki (
- ), . ,
,
,
( . 61-2).
( ) ( . ).
CREST ( , Raynaud,
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436
61  : 437

61-1
,

,
Parkinson .
,
, .

( ) .
, ,

(modified barium sallow)


(
),
(cricopharyngeal bar)
(FEES: fiberoptic
o
endoscopic evaluation of swallowing). FEES,

/ ,
Zenker
.
( . . ) FEES
,

.
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,
.

. ,
/ , ,

Schatzki
.

(dysphagia lusoria) ,
: , : - .
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. [
61-1, . ,
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438 VI 

61-1 .

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61  : 439

61-2 .

( ),
( ), (chin tuck)
. .

,
.
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, .
.
(bougies), ,

.
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Schatzki, -
440 VI 

61-2 ( Schatzki).

(tubular
esophagus)

(vestibule)

( )

( )

. , , .
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,

, stent
(ablation).

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PPIs ,
,
61  : 441

61-1

/
/ *
/ /
(PPI)

(stent)
(Heller)

Smooth-muscle relaxants (isosorbide dinitrate, nifedipine)


(PPI)

( )
PPI: proton pump inhibitor ( )
*
Cook IJ, Kahrilas PJ: AGA technical review on management of
oropharyngeal dysphagia. Gastroenterology 116(2):455-478, 1999.
, This comprehensive literature-based review examines the evaluation and
. management of patients with oropharyngeal dysphagia.
Ferguson DD: Evaluation and management of benign esophageal
,
strictures. Dis Esophagus 18(6):359-364, 2005.
. This review focuses on the options available for managing patients with
benign strictures, from simple dilation techniques to more complex issues for
refractory strictures.
,
Richter JE: Oesophageal motility disorders. Lancet 358(9284):823-828,
2001.
The author discusses the manometric diagnosis of recognized esophageal
. motility disorders and the management options available for these conditions.

1. Lopushinsky SR, Urbach DR: Pneumatic dilatation and surgical


myotomy for achalasia. JAMA 296(18):2227-2233, 2006.
(MII: multichannel This retrospective study found that patients with achalasia who had
undergone either pneumatic dilation or surgical myotomy often required
intraluminal impedance). MII subsequent intervention (surgical or endoscopic) when followed for many
years after their first treatment. The risk for requiring a subsequent
intervention was higher in the pneumatic dilation group.
2. Remedios M, Campbell C, Jones DM, Kerlin P: Eosinophilic
. esophagitis in adults: Clinical, endoscopic, histologic findings, and
response to treatment with fluticasone propionate. Gastrointest
Endosc 63(1):3-12, 2006.
The authors reported that all patients in their series who were treated
. with swallowed aerosolized fluticasone improved clinically and histologically,
but many had recurrent symptoms after completing the course of treatment.
, 3. Tutuian R, Castell DO: Combined multichannel intraluminal im-
pedance and manometry clarifies esophageal function abnormalities:
Study in 350 patients. Am J Gastroenterol 99(6):1011-1019, 2004.
This investigation highlighted the utility of multichannel intraluminal
impedance to show normal and abnormal bolus transit in several esophageal
, . , motility disorders.

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