SURGICAL CONSIDERATIONS OF ACHALASIA

Abstract

A variety of terms have been applied to the clinical syndrome characterized by dilatation and hypertrophy of the esophagus associated with nonorganic obstruction of the cardia. These include cardiospasm, achalasia, phrenospasm, idiopathic dilatation of the esophagus, esophagectasia, hiatal esophagismus, megaesophagus, simple ectasia of the esophagus, preventriculosis, dilatio ingluviformis oesophagi, dilatio fusiformis and dolichoesophagus. The multifarious designations clearly reveal the controversial causation and the bewildering pathogenesis of the condition. This is further reflected by the various types of therapeutic procedures which have been employed. It is considered inopportune to attempt here a detailed discussion of the different theories and concepts of the malady, as these have been adequately reviewed in previous publications.¹ However, it may be desirable to present briefly some of the factors which have been considered of pathogenic significance, in order to permit a better comprehension of the varied surgical therapeutic procedures that have been employed and advocated.