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首页> 外文期刊>Annals of the New York Academy of Sciences >How to approach esophagogastric junction outflow obstruction?
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How to approach esophagogastric junction outflow obstruction?

机译：如何接近食管胃部结流梗阻？

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The diagnosis of esophagogastric junction outflow obstruction (EGJOO) is currently based on high-resolution esophageal manometry and is characterized by impaired EGJ relaxation with preserved esophageal peristalsis. This condition has been defined by the Chicago Classification as a major esophageal motility disorder, although its clinical significance is controversial since heterogeneous and irrelevant presentations have been reported. EGJOO commonly has a benign clinical course, with spontaneous resolution, but it can also be associated with opioid usage, early achalasia, and mechanical obstruction. A careful medical, surgical, and medication history coupled with a careful manometry interpretation focused on the factors that might affect the integrated relaxation pressure are the keys for an accurate diagnosis. The advance of esophageal physiological tests can evaluate the clearance of the esophageal contents across the EGJ. The manometry technique, including testing in an upright position and provocative tests, can also complement those tests and demonstrate the evidence of EGJ obstruction. After making a diagnosis, endoscopy should be an initial step to exclude anatomical causes if it has not yet been done. Imaging studies can identify infiltrative lesions, but the reported diagnostic yield is relatively low. Management of EGJOO depends on the underlying etiology. Functional EGJOO patients with persistent dysphagia associated with the presence of outflow obstruction may require EGJ disruption therapy.
机译：目前基于高分辨率食管测量法的食管胃部结梗阻梗阻（EGJO）的诊断目前是基于高分辨率食管测量法，其特征在于egj egj reasopage peristalsis。这种病症已被芝加哥分类定义为主要食管运动障碍，尽管其临床意义是争议的，因为报告了异质和无关的介绍。 Egjoo通常具有良性临床课程，具有自发性分辨率，但它也可以与阿片类药物使用，早期贲门划分和机械阻塞有关。仔细的医疗，手术和药物历史与仔细的测压解释相结合，重点是可能影响综合放松压力的因素是准确诊断的键。食管生理试验的进展可以评估EGJ对食管内容的清除。测压技术，包括在直立位置和挑衅性测试中的测试，也可以补充那些测试并证明EGJ障碍的证据。在进行诊断后，如果尚未完成，内镜检查应该是排除解剖原因的初始步骤。成像研究可以识别渗透病变，但报告的诊断产量相对较低。 EGJO的管理取决于潜在的病因。功能性EGJOO患者持续存在吞咽困难障碍症的患者可能需要EGJ中断治疗。

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