Korean J Neurogastroenterol Motil.
2007 Jun;13(1):76-80.
A Case of Acid Reflux-associated Diffuse Esophageal Spasm aggravated after Acute Pancreatitis
- Affiliations
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- 1Department of Internal Medicine, Institute for Digestive Research, Soonchunhyang University, College of Medicine, Seoul, Korea. drjslee@dreamwiz.com
Abstract
- Diffuse esophageal spasm (DES) is a typical motility disorder of the esophagus thats manifested by episodic chest pain and dysphagia. Visceral hypersensitivity is considered to be an important pathophysiological mechanism in the development of noncardiac chest pain, the same as for functional gastrointestinal disorders. Recent studies have revealed that descending facilitation from the rostral ventromedial medulla maintains visceral pain in a model of experimental pancreatitis. We report here on a 24-year old male who suffered from retrosternal chest pain and dysphagia, and this was aggravated after acute pancreatitis. The initial endoscopic examination revealed reflux esophagitis. After 11 months, esophageal manometry showed the typical findings of diffuse esophageal spasm, while the endoscopic examination and 24 hr pH metry failed to reveal acid reflux. We performed endoscopic botulinum toxin injection that resulted in relieving his symptoms along with improved results on the balloon provocation test. We present here a case of aggravated reflux-associated DES after acute pancreatitis, along with a review of the literature.
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