Achalasia is a rare esophageal motility disorder characterized by the absence of the primary peristalsis, incomplete dilatation of the lower esophageal sphincter (LES), esophageal lumen dilatation, and increased esophageal internal pressure. Manometry is the most accurate diagnostic method for this disorder. Endoscopy or X-ray guided balloon dilatation, Botulinum injection to LES and Heller myotomy have been used for short-term or long-term therapy. Recently, peroral endoscopic myotomy (POEM) has been performed for increased treatment effect. However, it is difficult to completely cure achalasia due to highrecurrence...

TBE is performed in the erect posture under fluoroscopy. A low density barium sulphate suspension (45% weight by volume) is ingested orally within 15-20 seconds. The volume of suspension (usually 100 to 250 mL) should be such that patient can tolerate it well without regurgitation or aspiration and the dilated achalasic esophagus can be filled adequately. It is better to have a fixed volume as a standard protocol. Erect anterior posterior, left anterior and posterior oblique images are taken 1, 2 and 5 minutes after...

The mean increased value of LES after POEM was 5.5 mm, 2.9 mm, and 3.3 mm in group A (n=10), B (n=18) and C (n=4), respectively. Group A showed statistically significant (p < 0.01) treatment effect, compared with group B, but there was no statistically significant (p > 0.01) difference between group A and group C, or between group B and group C. Regarding on the esophageal shape on pre-POEM TBE, bird’s beak shape showed statistically significant (p < 0.01) treatment effect rather than other...

The treatment effect of POEM for achalasia was the most useful in group A with the narrowest LES and in patients with bird’s beak shape on TBE.

Jae-Joon Chung, Joo Hee Kim, Eun-Suk Cho, Jeong- Sik Yu Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonju-ro, Gangnam-gu, Seoul, 06273, Korea E-mail: [email protected]

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