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Sonographic Findings in Esophageal Achalasia

Author(s): Tsung-Hui Hu | Seng-Kee Chuah | Keng-Liang Wu | Wei-Chen Tai | Tai-Yi Chen | Yi-Chun Chiu | Ming-Luen Hu | Chi-Sin Changchien | Chuan-Mo Lee

Journal: Chang Gung Medical Journal
ISSN 2072-0939

Volume: 32;
Issue: 02;
Start page: 204;
Date: 2009;
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Keywords: conventional sonography | gastroesophageal junction | achalasia

Background: There are only three reports using conventional sonography to detect the gastroesophagealjunction through the left lobe liver window in patients withachalasia, and the results were inconsistent. This study further characterizesthe sonographic features of achalasia and compares them to characteristics ofsubjects with gastroesophageal malignancies.Methods: Conventional sonography was performed in 21 patients with achalasia (meanage 49.0 years, 11 male and 10 female, group A); 15 patients with malignanciesat the gastroesophageal junction (n = 10) and cardiac of the stomach (n= 5) (mean age 55.3 years, 11 male and 4 female, group B); and 30 subjectswith functional dyspepsia (mean age: 38.3 years, 15 male and 15 female,control group C).Results: The median esophageal wall thicknesses were 5.1 ± 2.3 mm (group A), 19.5± 7.8 mm (group B), and 3.3 ± 1.2 mm (group C). However, there wasoverlap in the esophageal wall thickness in groups A and C. Sonographicfeatures in group A were regular hypoechoic thickening of the wall at thegastroesophageal junction; in group B, we found irregular hypoechoic thickeningof the wall. Control subjects had a regular hypoechoic gastroesophagealwall. Dilated lumens of the distal esophagus were seen in all achalasiapatients.Conclusion: Although conventional sonography is not a diagnostic tool for achalasia, itprovides interesting sonographic information. It cannot reveal each layer ofthe wall of the lumen as endoscopic ultrasound does, but it may tentativelydifferentiate achalasia from malignancies and assists clinicians when endoscopicultrasound is not available.
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