Abstract
Introduction: Achalasia is an esophageal motor disorder. Patients with achalasia may have lung disorders-obstruction because of ''mega-esophagus'' compression on trachea or other respiratory symptoms due to microaspiration
Method: 27 patients with achalasia underwent pulmonary (spirometry, body plethysmography, helium dilution tests,CT) and gastrointestinal tests
Results: The mean age of patients was 51,5 years. The mean of dilated esophagus was 6 cm. All of patients have some of respiratory symptoms -cough, wheezing, fatigue, dyspnea. Nine patients (35%) had parenchymal lung changes on CT-3 with air trapping, 1 nodular changes, 1 consolidation, 4 with fibrosis. Fifteen patients (60%) had functional changes-28% obstructive and 32% restrictive. Nineteen (73%) had hyperinflation measured by plethysmography. But 61% of them was pseudo hyperinflation that has been demonstrated measuring by helium dilution test. This significant difference in the existence of hyperinflation is because the plethysmography covers whole body so there is included a greater amount of air that is in extended part of esophagus. That is demonstrated in measuring the helium dilution gas because only inhaled gas is retained in the lungs so we can see whether there is indeed an increase in the static volume and hyperinflation or not. For now we have only 6 patient's functional tests after operation, and 5 of them reduced i.e. normalized hyperinflation, which is another proof of the existence of pseudo hyperinflation
Conclusion: Awareness of association of achalasia and lung disorders is important in treatment because of false results such as obstruction and hyperinflation, and we can see that only if we done few more than standard tests and after operation.
- Copyright ©the authors 2016