the Gastrolab Endoscopy Quiz of the Month - Old Quizes and Answers: June 2004

the GASTROLAB Old Quiz

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The Old Endoscopy Quiz (and Answer) of the Month
June 2004

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Question:

Click on an image to get a magnification!

The summer of this year is here again - at least on our half of the globe. During the summer - in June, July and August - the Quiz will be quite easy for two reasons. First, a quick answers save You time to be out in the sun. Second, You do not have to be an expert in endoscopy to manage in this quiz during the summer. So - if You are a health care professional just thinking of starting a career in endoscopy, please have a try - You might find it interesting!

This young lady in her early fourties had suffered from some swallowing disorders for about one year and she had lost some weight. This is the endoscopic finding just above the Z-line in the cardia region. These images have been taken during an inspection of several minutes. The endoscope was then inserted into the stomach without any great difficulties. What is this finding?

Answer:

    Achalasia cardiae


    The cardia region of the same patient as above in an x-ray examation
    		 Achalasia cardiae is a motility disorder of the oesophagus, where there is a nerve degeneration in the Auerbach´s plexus, causing inability of the lower oesophageal sphincter in the cardia region (C) to relax. In oesophageal x-ray examanations a dilatation of the oesophagus is seen, and the contrast stays in the oesophagus for a long time. Endoscopy shows a quite normal cardia, and in less severe cases the endoscopic diagnose is not easy. Dysphagia is the main symptom, causing weight loss in severe cases. Achalasia can be treated with medicines (nifedipine, nitrates), botulinumtoxin injections in the cardia, dilatation during endoscopy and surgically (Heller´s myotomy).

Correct answers and comments were emailed by

    Christos Zavos, Thessaloniki, Greece
    Zahreddine Radwan, Beirut, Lebanon
    ALTN CEKODHIMA, TIRANA, ALBANIA
    Dr.CSBR.Prasad, Riyadh, CP, Saudi Arabia
    VALLADARES GUILLERMO, PERU
    Salvatore Della Ducata, Gallipoli, Italy
    Hurler, Ulrike, Heidenheim, Germany
    m.lerios, Nicosia, Cyprus
    BASSAM AHMAD MOUSSAWI, NABI CHIT, LEBANON
    AISSAOUI LOTFI, ARAR, ARABIA SAUDIA
    Csaba Gog, Mako, Hungary
    Docs, Italy
    Mansour Al Shehadat, Damascus, Syria
    Abdon Guerra, San Antonio, Chile
    SHEIKH ANWAR ABDULLAH, KUALA LUMPUR., MALAYSIA

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