Esophageal involvement is found in more than half of patients with systemic sclerosing diseases. Peristalsis and LES tonus are markedly diminished, allowing reflux of corrosive gastric juice. Other causes of impaired esophageal motility are diabetes mellitus, renal failure, neuropathies, and myopathies.
Fig. 3.55 Manometric findings in nutcracker esophagus. The traces show hypertonic propulsive contractions of prolonged duration in the tubular esophagus. The LES shows a normal resting pressure with adequate relaxation in response to swallowing (from: Hahn and Riemann, Klinische Gastroenterologie. Vol. I, 3 rd ed. Stuttgart: Thieme 1996) les = lower esophageal sphincter sw = swallow
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