A Case of Nutcracker Esophagus Combined with Hypertensive Lower Esophageal Sphincter.
- Author:
Seong Hun KIM
1
;
Ju Suk LEE
;
Su Eun PARK
;
Sang Ook NAM
;
Jae Hong PARK
Author Information
1. Department of Pediatrics, College of Medicine, Pusan National University, Pusan, Korea
- Publication Type:Case Report
- Keywords:
Nutcracker esophagus;
Hypertensive lower esophageal sphincter
- MeSH:
Barium;
Chest Pain;
Child;
Deglutition Disorders;
Dilatation;
Eating;
Endoscopy;
Esophageal Motility Disorders*;
Esophageal Sphincter, Lower*;
Esophagus;
Female;
Humans;
Peristalsis;
Reference Values;
Relaxation;
Vomiting
- From:Journal of the Korean Pediatric Society
1998;41(9):1288-1292
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Nutcracker esophagus and hypertensive lower esophageal sphincter (LES) are primary esophageal motility disorders. Nutcracker esophagus have demonstrated distal esophageal contraction amplitude that exceeds the normal range (>160mmHg), without association abnormalities of the esophageal contraction wave, or lower esophageal sphinter relaxation. The criteria for diagnosing hypertensive LES take the mean LES pressure >45mmHg, LES relaxation >75% and normal peristalsis, which is a poorly characterized motility disorder associated with chest pain and dysphagia. We experienced a case of nutcracker esophagus combined with hypertensive LES in a 3-year- old girl who presented with projectile vomiting immediately after eating solid foods. After she had taken barium esophagography and esophageal endoscopy, we suspected she had esophageal motor disorder. Esophageal manometric findings show abnormal high pressure of LES (mean LES pressure, 52.9 mmHg), abnormal high amplitude of lower esophagus more than 320 mmHg, normal esophageal perisaltic movement and normal LES relaxation. After pneumatic dilatation, now she can eat semisolid foods. This case may be the first case of nutcracker esophagus combined with hypertemsive LES in children.
