Portal de Periódicos da CAPES

Treatment of achalasia by injection of botulinum toxin under endoscopic ultrasound guidance

1997; Elsevier BV; Volume: 45; Issue: 1 Linguagem: Inglês

10.1016/s0016-5107(97)70306-7

1097-6779

Brenda J. Hoffman, W Knapple, Manoop S. Bhutani, G.Nicholas Verne, Robert H. Hawes,

Esophageal and GI Pathology

Idiopathic achalasia is a well-recognized esophageal motor disorder that is characterized by esophageal aperistalsis and an elevated lower esophageal sphincter (LES) pressure with incomplete relaxation after swallowing. In achalasia, there is a loss of ganglion cells within the myenteric plexus of the LES. In addition to destruction of ganglion cells, postganglionic neurons that facilitate relaxation of the LES are selectively damaged in achalasia. Immunohistochemical studies have demonstrated a reduction of nitric oxide and vasoactive intestinal peptide staining in the LES neurons in patients with achalasia.