Diffuse esophageal spasm
The diffuse esophageal spasm (Barsony-Teschendorf syndrome) is a motility disorder of the esophagus with repeated often paroxysmal occurring, segmental, non- propulsive contractions of the smooth muscle component.
Symptoms
Pain behind the breastbone can occur during an attack, which sometimes cannot be clearly distinguished from anginal pain . Hence the term "Non-Cardiac Chest Pain". Often one occurs dysphagia on.
Diagnosis
It is not always possible to depict pearl-string-like or corkscrew-shaped contractions in the porridge swallowing examination , since the esophagus can appear completely inconspicuous in between. In the positive case and with simultaneous subjective symptoms, a diffuse esophageal spasm is very likely the cause. The spastic segmental contractions can result in contact with the walls of the esophagus. The large sections of the esophagus in between can look like diverticula. The term "Barsony diverticulum" is used for this, although it is not a real diverticulum in the radiological sense and should better be called Barsony pseudodiverticulum.
The esophageal manometry can register the pressure conditions in the esophagus over a longer period of time and is therefore diagnostically more sensitive than the swallow x-ray examination for the occurrence of seizures with symptom-free intervals .
A special form of diffuse spasm is the corkscrew esophagus, which is based on a spiral, elongated contraction. A spiral staircase-like course of the esophagus can be observed endoscopically in this clinical picture.
Differential diagnostics
The nutcracker esophagus is to be distinguished , in which the peristaltic wave is downright propulsive, but with a significantly increased manometrically detectable amplitude. The disorder called Jackhammer esophagus (steam hammer esophagus) in English-speaking countries is characterized by long-lasting contractions.
literature
- Freyschmidt, Feuerbach: Manual of diagnostic radiology: Gastrointestinal system . Springer 2006, ISBN 9783540684725
- AR Margulis, HJ Burhenne: Practical Alimentary Tract Radiology , Mosby-Year Book 1993, St. Loius Missouri, ISBN 0801631335
- T.Wehrmann: Esophageal manometry in functional diagnostics in gastroenterology . Springer 2006, ISBN 3540256709
