Document Detail

Clinical, radiographic, and manometric evolution of esophageal involvement by Chagas' disease.
MedLine Citation:
PMID:  15886966     Owner:  NLM     Status:  MEDLINE    
The complete manifestation of esophageal Chagas' disease includes nonperistaltic contractions in the esophageal body, absent lower esophageal sphincter (LES) relaxation, and dilatation of the organ. However, some patients have a minor degree of esophageal denervation and esophageal motility that does not imply a diagnosis of achalasia. Our objective was to evaluate the evolution of esophageal involvement by Chagas' disease in 28 patients with dysphagia for solids and liquids and a positive serologic test for the disease, 14 with complete LES relaxation, 4 with partial (incomplete) LES relaxation, and 10 with absent LES relaxation; only 2 of them had mild dilatation. The patients (21 women), aged 43-74 years (median 60 years), were evaluated by clinical, radiographic, and manometric methods that were repeated 3-14 years (median 7 years) later. Dysphagia improved in 13 (46.4%) patients, was worse in 5 (17.9%), and did not change in 10 (35.7%). The radiographic examination did not change in 24 (85.7%) and was worse in 3 (10.7%). Esophageal manometry revealed a change from peristaltic to simultaneous contractions in 2 patients (7.1%), LES relaxation changed from complete to partial in 5 (17.9%), and from partial to absent in 2 (7.1%). There was no further clinical, radiographic, or manometric impairment in 15 (53.6%) patients. The symptom duration was longer and the age when they were evaluated was older in patients with no progression of the disease. We conclude that a conspicuous part of this group of patients with esophageal Chagas' disease and dysphagia had no progression of esophageal disease after 3-14 years. This possibility should be considered when making therapeutic decisions.
Ulysses G Meneghelli; Fernanda M Peria; Fabiana M R Darezzo; Fernando H Almeida; Carla M Rodrigues; Lilian R O Aprile; Roberto O Dantas
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Dysphagia     Volume:  20     ISSN:  0179-051X     ISO Abbreviation:  Dysphagia     Publication Date:  2005  
Date Detail:
Created Date:  2005-05-11     Completed Date:  2005-10-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8610856     Medline TA:  Dysphagia     Country:  United States    
Other Details:
Languages:  eng     Pagination:  40-5     Citation Subset:  IM    
Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, Ribeirão Preto, Brazil.
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MeSH Terms
Chagas Disease / diagnosis,  physiopathology*
Disease Progression
Esophageal Motility Disorders / diagnosis,  etiology,  physiopathology*
Esophageal Sphincter, Lower / physiopathology*,  radiography
Middle Aged
Muscle Contraction / physiology
Muscle Relaxation / physiology
Peristalsis / physiology
Prospective Studies

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