Presenting Author: LINGYUN ZHANG Additional Authors: YU LAN, QI WANG Corresponding Author: YU LAN Affiliations: Jishuitan hospital Objective: This study was to find out the pathogenesis and guide the treatment of dysphagia by the analysis of the high-resolution manometry inspections of Fulvestrant chemical structure the patients with non-organic esophageal obstruction dysphagia. Methods: 42 patients (age 22∼79, 13 male) with dysphagia diagnosed from March, 2010 to May, 2012

were observed. Of the patients, 7 cases were with diabetes mellitus (DM), 9 cases were with connective tissue disorder (CTD), and 22 cases were with gastroesophageal reflux disease (GERD). All the patients received upper gastrointestinal endoscopy examination, and the cases with organic obstruction were excluded. Then, they received the examination selleck products of solid-state high-resolution manometry. The manometric protocol included a 5-min assessment of low esophageal sphincter pressure (LESP) and ten 5-mL water swallows. We observed the esophageal body pressure, pressurization front velocity (PFV), LESP and LES relaxation pressure (RP) of every swallow. When the swallow was with the pressure of proximal esophageal body 12∼180 mmHg, of the distal 30∼180 mmHg and PFV < 8 cm/s, we considered the swallow as normal.

The abnormal swallow included hypotensive (<5-cm defect in the domain of subnormal pressure), failed (> 5-cm defect in the domain of subnormal pressure), rapidly conducted (PFV ≥ 8 cm/s), hypertensive (contraction

pressure of the esophageal body ≥180 mmHg). Normal esophageal motility was difined as: PFV < 8 cm/s in > 90% of swallows, normal contraction pressure in > 70% of swallows, LESP 10–45 mmHg and RP < 8 mmHg. Abnormal esophageal motilities included impaired LES relaxation (RP ≥ 8 mmHg), nutcracker esophagus (hypertensive contraction pressure in ≥30% and non-rapidly conducted in > 90% of wallows), esophageal spasm (rapidly conducted in > 20% of swallows), peristaltic dysfunction, and others. Peristaltic dysfunction included two types: Mild: 30%~70% of the swallows were MCE公司 hypotensive contractions; severe: ≥70% were hypotensive contractions. Results:  13 (30%)cases were with normal esophageal motility. 12 (28.6%)cases were with impaired LES relaxation. Among the 12 cases, 3 cases were achalasia with failed or rapidly conducted contraction; 5 cases were with hypertensive contractions at 5 cm above LES in 20%∼30% of swallows; 3 cases were with hypotensive contraction at 10 cm above LES in 10%∼60% of swallows; 1 case was with failed contraction in proximal esophagus. 2 (4.8%)cases were with nutcracker esophagus; 3 (7.1%)cases were with esophageal spasm; 7 (16.7%)cases were with mild peristaltic dysfunction; 4 (9.5%)cases were with severe peristaltic dysfunction; 1 case was with only lower LESP. Table 1 showed the patients with different esophageal motilities and diseases.