Introduction:

Achalasia is a primary esophageal motor disorder characterized by the absence of esophageal peristalsis and relaxation of the lower esophageal sphincter secondary to damage of the myenteric plexus. A prevalence of <1/10,000 and an incidence between 0.03 and 1/100,000 per year. It is usually diagnosed between the ages of 30 and 60, and both genders seem to be equally affected. In the United States, endoscopy is the first test in the assessment of dysphagia that is suspected to be of esophageal origin, regardless of the differential diagnosis. In patients with achalasia, endoscopy may show esophageal dilation, food or fluid retention, or rarely cancer. The lower esophageal sphincter may look wrinkled and remain closed with air insufflation. Type I achalasia is characterized by failed contractions and absence of pressurization. Type II achalasia is defined by pan-esophageal pressurization and type III achalasia due to the presence of spastic or premature contractions. Studies have shown that type II achalasia, the most common subtype, seems to have the most favorable response to treatment, while type III, the less common subtype, seems to have the least favorable response.

Objective:

To determine the usefulness of endoscopy in the diagnosis of achalasia.

Material and methods:

Cross-sectional, retrospective, descriptive, unicentric study. We included patients with a diagnosis of probable esophageal motor disorder by endoscopy, who underwent high-resolution manometry at the endoscopy unit of the Hospital Juárez de México from January 2016 to December 2018. The following parameters were analyzed in the patients: sex, age, type of achalasia according to the Chicago classification and endoscopic findings. Data were obtained from the database of the endoscopy unit of Hospital Juárez de México and from the clinical file of each patient, creating a database in SPSS version 25.0

Results and conclusions:

19 patients were included, 73.7% female (N = 14) and 26.3% male (N = 5), age group with the highest prevalence of 40-49 years of age with 31.58% (N = 6). Among the most commonly reported endoscopic findings are esophageal dilation, food retention and functional stenosis in 52.6% of patients. With 63.2% (N = 12) type II achalasia according to the Chicago classification was the most commonly diagnosed by high-resolution manometry. In the 89.47% (N = 17) of the patients in whom esophageal motor disorder was reported, the diagnosis of achalasia was confirmed by high-resolution manometry.

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