New endoscopic classification of the cardiac orifice in esophageal achalasia: Champagne glass sign

Kuniyo Gomi; Haruhiro Inoue; Haruo Ikeda; Robert Bechara; Chiaki Sato; Hiroaki Ito; Manabu Onimaru; Yohei Kitamura; Michitaka Suzuki; Jun Nakamura; Yoshitaka Hata; Shota Maruyama; Kazuya Sumi; Hiroshi Takahashi

doi:10.1111/den.12642

journal article Apr 21, 2016

New endoscopic classification of the cardiac orifice in esophageal achalasia: Champagne glass sign

Kuniyo Gomi Haruhiro Inoue Haruo Ikeda

Robert Bechara

Chiaki Sato

Hiroaki Ito

Manabu Onimaru Yohei Kitamura Michitaka Suzuki Jun Nakamura Yoshitaka Hata Shota Maruyama Kazuya Sumi

Hiroshi Takahashi

Digestive Endoscopy Vol. 28 No. 6 pp. 645-649 · Wiley

View at Publisher Save 10.1111/den.12642

Abstract

Background and AimEndoscopy, barium esophagram and manometry are used in the diagnosis of achalasia. In the case of early achalasia, characteristic endoscopic findings are difficult to recognize. As a result, the diagnosis of achalasia is often made several years after symptom onset. Therefore, we examined the endoscopic findings of the cardiac orifice in achalasia and propose a new classification.MethodsA total of 400 patients with spastic esophageal motility disorders who underwent peroral endoscopic myotomy (POEM) at our hospital between March 2014 and August 2015 were screened for this study. Champagne glass sign (CG) was defined as when the distal end of the lower esophageal sphincter relaxation failure (LESRF) was proximal to the squamocolumnar junction (SCJ) and the SCJ was dilated in the retroflex view. Specifically, CG‐1 was defined as a distance from the SCJ to the lower end of LESRF of <1 cm, and CG‐2 was defined as a distance ≥1 cm.ResultsCG‐0 was seen in 73 patients (28.0%), whereas the CG sign was seen in 186 patients (71.3%), of whom 170 (65.1%) were CG‐1 and 16 (6.1%) were CG‐2.ConclusionsThe CG sign is often observed in esophageal achalasia patients. CG‐0 (equal to Maki‐tsuki) was observed in 28.0% of achalasia patients only. Its absence with dilated SCJ cannot be used to rule out achalasia. Barium esophagram and manometry should be done if esophageal achalasia is strongly suspected.

Topics

No keywords indexed for this article. Browse by subject →

References

4

[1]

10.1136/gut.33.8.1011

[2]

10.1007/s00535-009-0179-7

[3]

The Japan Esophageal Society.Diagnosis.Tokyo:Kanehara & Co. Ltd. p.3.

[4]

10.1055/s-0029-1244080

Cited By

14

Gastrointestinal: Esophageal Achalasia With Unusual Endoscopic Findings

Kazuya Sumi, Haruhiro Inoue · 2024

Journal of Gastroenterology and Hep...

Metrics

14

Citations

4

References

Details

Published: Apr 21, 2016
Vol/Issue: 28(6)
Pages: 645-649
License: View

Authors

K

Kuniyo Gomi