to define the procedure of surgery

1. ACHALASIA CARDIA
Presented by:
Dr. Rubab Nafees
MBBS, FCPS
(G.Surgery)

2. DEFINITION
ACHALASIA IS A MOTILITY DISORDER OF THE
ESOPHEGUS CHARATERRIZED BY THE ABSENCE
OF PERITASIS AND THE FAILURE
OFRELAXATION OF LOWER ESOPHEGAL
SPHINCTER.
THIS CAUSE OBSTRUCTIONAT THE LEVEL OF
ESOPHEGEAL GASTRIC JUNCTION.

3. INCIDENCE
•COMMON IN ADULTS (AGE 25-40YRS).
•ONLY 5% IN CHILDREN.
•ALSO OCCURS IN ELDERLY ASSOCIATION
WITH MELAGANCY.

4. PATHOPHYSIOLOGY
ACHALASIA IS CHARACTERIZED BY
INCREASED IN LOWER ESOPHEGEAL
SPINCTER PRESSURE, DECREASED OR
ABSENT IN PERISTASIS IN THE DISTAL
PORTION OF THE ESOPHEGAUS, AND
THE LACK OF LES RELAXATION IN
RESPONSE TO SWELLWING.

5. AETOLOGY
•EXACT CAUSE IS NOT KNOWN.
•DEGENERATION OF MYENTERIC PLEXUS.
•THE LOSS OF INHIBITORY NEURONS ALLOWS
UPPOSED STIMULATION BY CHOLONERGIC
NEUORONS WHICH LEADS TO FAILURE IN
L.E.S. RELAXATION AND APERITALISIS OF
DISTAL OESOGHEGUS.