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식도위 접합부 출구 폐쇄의 진단적 접근

Diagnostic Approach for Esophagogastric Junction Outflow Obstruction

대한소화기학회지 2020년 76권 4호 p.179 ~ 184
조유경,
소속 상세정보
조유경 ( Cho Yu-Kyung ) - Catholic University College of Medicine Department of Internal Medicine

Abstract


Esophageal manometry is the gold standard test for diagnosing primary esophageal motility disorder. With the various metrics of the high-resolution esophageal manometry, the Chicago classification provides a standard approach for the manometric diagnosis of esophageal motor disorders. In the Chicago classification, the esophagogastric junction dysfunction is an important major motor disorder, which includes achalasia subtypes and esophagogastric junction outflow obstruction. Esophagogastric junction outflow obstruction is defined manometrically as normal or weak esophageal peristalsis with incomplete relaxation of the lower esophageal sphincter. It is a heterogeneous disorder and usually has a benign clinical course. The small portion of an esophagogastric junction outflow obstruction is early or variant achalasia. In such cases, treatments directing the lower esophageal sphincter, such as balloon dilatation or per oral endoscopic myotomy, may be necessary. An adjunctive high-resolution manometry provocation test or other esophageal function tests, such as timed barium esophagogram, can help select those patients and predict the treatment outcomes.

키워드

Deglutative disorders; Esophagus; Obstruction

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