Is it necessary to perform a morphological assessment for an esophageal motility disorder? A retrospective descriptive study.
(2021) Clinics and Research in Hepatology and Gastroenterology — Vol. 45, n° 6, p. 101633 [1-9] (2021)
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- (en) BACKGROUND: Esophageal motility disorders are most often of primary origin but may be secondary to an occult malignancy or another etiology. High-resolution esophageal manometry cannot differentiate between secondary or primary origin. This study aimed at discussing the usefulness of a morphological assessment in the diagnosis of specific esophageal motility disorders, and to establish the predictive factors of a potential secondary origin. METHODS: In this retrospective study, patients with suspected esophageal motility disorders who underwent an esophageal manometry were included. High-resolution manometry results were interpreted according to the Chicago Classification, 3rd version. The results of endoscopic ultrasound and computed tomography, assessed by a panel of experts, allowed to diagnose a secondary origin. KEY RESULTS: Out of 2138 patients undergoing manometry, 502 patients had a esophageal motility disorder suspect to be from secondary origin; among them 182 patients underwent tomography or endoscopic ultrasound. According to experts, 16 patients (8.8%) had a secondary esophageal motility disorder: esophagogastric junction outflow obstruction (n = 7), jackhammer disorder (n = 4), achalasia (n = 3) and localized pressurization (n = 2). The etiology was malignant in 8 patients. Predictive factors suggesting potential secondary esophageal motility disorders were smoking, age ≥ 58 years and an Integrated Relaxation Pressure higher than 10 mmHg for water swallows. CONCLUSION AND INFERENCES: Esophageal motility disorders with organic origin are not uncommon. A morphological assessment using endoscopic ultrasonography and/or computed tomography may be of use to diagnose a secondary origin, especially in the elderly and smokers.
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Latrache, S., Melchior, C., Desprez, C., Sidali, S., Recton, J., Touchais, O., van der Eecken, E., Wuestenberghs, F., Charpentier, C., Leroi, A. M., & Gourcerol, G. (2021). Is it necessary to perform a morphological assessment for an esophageal motility disorder? A retrospective descriptive study. Clinics and Research in Hepatology and Gastroenterology, 45(6), 101633 [1-9]. https://doi.org/10.1016/j.clinre.2021.101633 (Original work published 2021)