<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1409-0015</journal-id>
<journal-title><![CDATA[Medicina Legal de Costa Rica]]></journal-title>
<abbrev-journal-title><![CDATA[Med. leg. Costa Rica]]></abbrev-journal-title>
<issn>1409-0015</issn>
<publisher>
<publisher-name><![CDATA[Asociación Costarricense de Medicina Forense]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1409-00152016000100269</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Acalasia como trastorno de la motilidad esofágica]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferrandino Carballo]]></surname>
<given-names><![CDATA[Fiorella]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Umaña Brenes]]></surname>
<given-names><![CDATA[Alberto Alonso]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Costa Rica  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de Costa Rica  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2016</year>
</pub-date>
<volume>33</volume>
<numero>1</numero>
<fpage>269</fpage>
<lpage>274</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S1409-00152016000100269&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S1409-00152016000100269&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S1409-00152016000100269&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: La acalasia es un trastorno esofágico, de tipo motor primario y de etiología desconocida, que fue descubierta por Sir Thomas Williams en 1674. Se presenta por igual en hombres y mujeres, siendo la edad habitual de presentación entre los 25 y 60 años. Fisiopatológicamente, hay un proceso inflamatorio que conlleva a la pérdida de neurotransmisores inhibitorios y a un desbalance entre neuronas inhibitorias y excitatorias. Esto desencadena una aumentada actividad colinérgica, que ocasiona la relajación incompleta del esfínter esofágico inferior (EEI). Clínicamente, el paciente presenta disfagia, regurgitación, pirosis, halitosis, dolor torácico y disfonía. La manometría en alta resolución constituye junto con la anamnesis los métodos diagnósticos de elección, manométricamente se caracteriza por relajación insuficiente del EEI y pérdida de la peristalsis esofágica. Radiográficamente se documenta aperistalsis, dilatación esofágica con apertura mínima del EEI, apariencia en &#8220;pico de ave&#8221;, así como escaso vaciamiento del bario. Endoscópicamente se visualiza dilatación esofágica con retención de saliva, líquido y partículas de alimento no digeridas en ausencia de estenosis de la mucosa o tumores. El tratamiento incluye opciones como fármacos, inyección de toxina botulínica, dilatación neumática, miotomía y esofagectomía.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Achalasia is an esophageal, primary motor disorder of unknown etiology, which was discovered by Sir Thomas Williams in 1674. It occurs equally in men and women, with the usual age of onset between 25 and 60 years. Pathophysiologically, there are an inflammatory process leading to a loss of inhibitory neurotransmitters and an imbalance between inhibitory and excitatory neurons. This triggers an increased cholinergic activity, which causes incomplete relaxation of the lower esophageal sphincter (LES). Clinically, the patient presents dysphagia, regurgitation, heartburn, dyspnea, chest pain and dysphonia. High resolution manometry constitutes together with the anamnesis, the gold standard for diagnosis. Manometry is characterized by insufficient LES relaxation and loss of esophageal peristalsis. Aperistalsis, esophageal dilation with minimal LES opening, &#8220;bird-peak&#8221; appearance, and poor emptying of barium are radiographically documented. Dilated esophagus with retention of saliva, liquid and undigested food particles in the absence of stenosis or mucosal tumors, are the main findings of the endoscopy. Treatment includes options such as drugs, botulinum toxin injection, pneumatic dilatation, myotomy, and esophagectomy.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Esófago]]></kwd>
<kwd lng="es"><![CDATA[acalasia del esófago]]></kwd>
<kwd lng="es"><![CDATA[trastornos de deglución]]></kwd>
<kwd lng="es"><![CDATA[esfínter esofágico inferior]]></kwd>
<kwd lng="es"><![CDATA[trastornos de la motilidad esofágica]]></kwd>
<kwd lng="es"><![CDATA[manometría esofágica]]></kwd>
<kwd lng="en"><![CDATA[Esophagus]]></kwd>
<kwd lng="en"><![CDATA[esophageal achalasia]]></kwd>
<kwd lng="en"><![CDATA[deglutition disorders]]></kwd>
<kwd lng="en"><![CDATA[lower esophageal sphincter]]></kwd>
<kwd lng="en"><![CDATA[esophageal motility disorders, esophageal manometry]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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