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September 1986

Transition From Peristaltic Esophageal Contractions to Diffuse Esophageal Spasm

Author Affiliations

From the Gastroenterology Unit, Department of Internal Medicine, Yale University School of Medicine, New Haven, Conn. Dr McCallum is now with the Division of Gastroenterology, University of Virginia School of Medicine, Charlottesville.

Arch Intern Med. 1986;146(9):1844-1846. doi:10.1001/archinte.1986.00360210242040

• A patient with dysphagia and chest pain was shown by manometry to have high-amplitude peristaltic esophageal contractions (nutcracker esophagus). Worsening symptoms over the next two years led to the performance of repeated manometric studies, which showed diffuse esophageal spasm. This demonstration of a transition from nutcracker esophagus to diffuse esophageal spasm lends further support for consideration of the nutcracker esophagus as a manometric disorder associated with chest pain or dysphagia. Furthermore, it suggests a pathophysiologic relationship between the nutcracker esophagus, a disorder with preserved peristalsis, and diffuse esophageal spasm, the classic dysmotility considered to be of neurogenic origin.

(Arch Intern Med 1986;146:1844-1846)

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