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February 25, 1956


JAMA. 1956;160(8):703-704. doi:10.1001/jama.1956.02960430093024

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To the Editor:—  I would like to comment on an editorial entitled "Dilatation of Esophagus (Megaesophagus)" in the Dec. 31, 1955, issue of The Journal, page 1742, in which a paper written by Effler and Rogers is cited. Instead of simplifying the subject, these authors have confused the issue further in attempting to define two separate entities; namely, "functional cardiospasm," or achalasia without dilation of the esophagus, and megaesophagus with obvious dilation of the organ. These conditions are one and the same, and, as long as the etiology is unknown, the term cardiospasm should suffice. Symptomatic intermittent obstruction of food at the cardia, with transient or poorly defined obstruction of a swallowed suspension of barium, should not be dignified by the term cardiospasm. As a matter of fact, in patients having this symptom, careful roentgenoscopic examination in the Trendelenburg position will frequently reveal a hiatal diaphragmatic hernia of the sliding

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