食管胃交界流出梗阻的难题：关键临床问题的解答

IF 4.1 3区综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES

Annals of the New York Academy of Sciences Pub Date : 2025-06-02 DOI:10.1111/nyas.15362

Kristle Lee Lynch, C. Prakash Gyawali, Enrique Coss‐Adame, Stefano Siboni, Christopher Vélez, Abraham Khan, Pierfrancesco Visaggi, Joshua A. Sloan, Sravanya Gavini, Marco Sozzi, Justin Wu

{"title":"食管胃交界流出梗阻的难题：关键临床问题的解答","authors":"Kristle Lee Lynch, C. Prakash Gyawali, Enrique Coss‐Adame, Stefano Siboni, Christopher Vélez, Abraham Khan, Pierfrancesco Visaggi, Joshua A. Sloan, Sravanya Gavini, Marco Sozzi, Justin Wu","doi":"10.1111/nyas.15362","DOIUrl":null,"url":null,"abstract":"Esophagogastric junction outflow obstruction (EGJOO) is a heterogeneous disorder characterized by abnormal esophagogastric junction residual pressures in the setting of intact esophageal body peristalsis. This manometric finding is most clinically relevant in patients with dysphagia and chest pain, and may arise from various mechanisms, including structural processes, catheter positioning artifact, and medications. Rarely, manometric EGJOO is a consequence of abnormal relaxation of the lower esophageal sphincter (LES) akin to achalasia. Thus, it is critical in the evaluation of EGJOO to determine if a true pressure gradient exists across the esophagogastric junction (EGJ) that warrants therapy. There are many unanswered questions in EGJOO diagnosis and management, which are addressed in this review in the context of the use of provocative maneuvers during high‐resolution manometry, complementary and alternate testing, and therapeutic options.","PeriodicalId":8250,"journal":{"name":"Annals of the New York Academy of Sciences","volume":"25 1","pages":""},"PeriodicalIF":4.1000,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The conundrum of esophagogastric junction outflow obstruction: Answers to key clinical questions\",\"authors\":\"Kristle Lee Lynch, C. Prakash Gyawali, Enrique Coss‐Adame, Stefano Siboni, Christopher Vélez, Abraham Khan, Pierfrancesco Visaggi, Joshua A. Sloan, Sravanya Gavini, Marco Sozzi, Justin Wu\",\"doi\":\"10.1111/nyas.15362\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Esophagogastric junction outflow obstruction (EGJOO) is a heterogeneous disorder characterized by abnormal esophagogastric junction residual pressures in the setting of intact esophageal body peristalsis. This manometric finding is most clinically relevant in patients with dysphagia and chest pain, and may arise from various mechanisms, including structural processes, catheter positioning artifact, and medications. Rarely, manometric EGJOO is a consequence of abnormal relaxation of the lower esophageal sphincter (LES) akin to achalasia. Thus, it is critical in the evaluation of EGJOO to determine if a true pressure gradient exists across the esophagogastric junction (EGJ) that warrants therapy. There are many unanswered questions in EGJOO diagnosis and management, which are addressed in this review in the context of the use of provocative maneuvers during high‐resolution manometry, complementary and alternate testing, and therapeutic options.\",\"PeriodicalId\":8250,\"journal\":{\"name\":\"Annals of the New York Academy of Sciences\",\"volume\":\"25 1\",\"pages\":\"\"},\"PeriodicalIF\":4.1000,\"publicationDate\":\"2025-06-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of the New York Academy of Sciences\",\"FirstCategoryId\":\"103\",\"ListUrlMain\":\"https://doi.org/10.1111/nyas.15362\",\"RegionNum\":3,\"RegionCategory\":\"综合性期刊\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MULTIDISCIPLINARY SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of the New York Academy of Sciences","FirstCategoryId":"103","ListUrlMain":"https://doi.org/10.1111/nyas.15362","RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MULTIDISCIPLINARY SCIENCES","Score":null,"Total":0}

引用次数: 0

摘要

食管胃交界流出梗阻（EGJOO）是一种异质性疾病，其特征是在食管体完整蠕动的情况下，食管胃交界残余压力异常。这一测量结果在吞咽困难和胸痛患者中最具临床相关性，可能由多种机制引起，包括结构过程、导管定位伪影和药物。很少有压力性EGJOO是食管下括约肌（LES）异常松弛的结果，类似于贲门失弛缓症。因此，评估EGJOO至关重要的是要确定食管胃交界处（EGJ）是否存在真正的压力梯度，从而保证治疗。在EGJOO的诊断和管理中有许多未解决的问题，这些问题在本综述中通过在高分辨率测压、补充和替代测试以及治疗选择中使用刺激性操作来解决。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

The conundrum of esophagogastric junction outflow obstruction: Answers to key clinical questions

Esophagogastric junction outflow obstruction (EGJOO) is a heterogeneous disorder characterized by abnormal esophagogastric junction residual pressures in the setting of intact esophageal body peristalsis. This manometric finding is most clinically relevant in patients with dysphagia and chest pain, and may arise from various mechanisms, including structural processes, catheter positioning artifact, and medications. Rarely, manometric EGJOO is a consequence of abnormal relaxation of the lower esophageal sphincter (LES) akin to achalasia. Thus, it is critical in the evaluation of EGJOO to determine if a true pressure gradient exists across the esophagogastric junction (EGJ) that warrants therapy. There are many unanswered questions in EGJOO diagnosis and management, which are addressed in this review in the context of the use of provocative maneuvers during high‐resolution manometry, complementary and alternate testing, and therapeutic options.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Annals of the New York Academy of Sciences 综合性期刊-综合性期刊

CiteScore

11.00

自引率

1.90%

发文量

193

审稿时长

2-4 weeks

期刊介绍： Published on behalf of the New York Academy of Sciences, Annals of the New York Academy of Sciences provides multidisciplinary perspectives on research of current scientific interest with far-reaching implications for the wider scientific community and society at large. Each special issue assembles the best thinking of key contributors to a field of investigation at a time when emerging developments offer the promise of new insight. Individually themed, Annals special issues stimulate new ways to think about science by providing a neutral forum for discourse—within and across many institutions and fields.