Hypercontracting (nutcracker) oesophagus
Last revised by Daniel J Bell on 15 Dec 2021
Citation, DOI, disclosures and article data
Citation:
Radswiki T, Bell D, Hacking C, et al. Hypercontracting (nutcracker) oesophagus. Reference article, Radiopaedia.org (Accessed on 25 Apr 2024) https://doi.org/10.53347/rID-12800
Permalink:
rID:
12800
Article created:
12 Jan 2011,
The Radswiki ◉
Disclosures:
At the time the article was created The Radswiki had no recorded disclosures.
View The Radswiki's current disclosures
Last revised:
15 Dec 2021,
Daniel J Bell ◉
Disclosures:
At the time the article was last revised Daniel J Bell had no recorded disclosures.
View Daniel J Bell's current disclosures
Revisions:
15 times, by
10 contributors -
see full revision history and disclosures
Systems:
Sections:
Tags:
Synonyms:
- Nutcracker oesophagus
- Nutcracker esophagus
- Hypercontracting oesophagus
- Hypercontracting esophagus
- Jackhammer oesophagus
- Nutcracker oesophaguses
- Nutcracker oesophagi
- Nutcracker esophaguses
- Nutcracker esophagi
- Hypercontracting oesophagi
- Hypercontracting oesophaguses
- Hypercontracting esophaguses
- Hypercontracting esophagi
Hypercontracting (nutcracker) oesophagus is a motility disorder of the oesophagus. This condition is primarily diagnosed with manometry with high intra-oesophageal pressure and normal peristalsis. Most patients will have a normal barium swallow.
Hypercontracting oesophagus ("nutcracker oesophagus") differs from diffuse oesophageal spasm (corkscrew oesophagus).
On this page:
Epidemiology
Hypercontracting oesophagus occurs in 10% of patients with non-cardiac chest pain.
Associations
- obesity 6
Clinical presentation
Presentation includes chest pain, dysphagia, and gastro-oesophageal reflux disease.
Pathology
Aetiology
Aetiology is unknown but may be related to gastro-oesophageal reflux or stress 2.
Radiographic features
Fluoroscopy
A barium swallow is usually normal. A minority of patients may demonstrate features of non-specific oesophageal motility disorder 1,2.
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Differential diagnosis
References
- 1. Ott DJ, Richter JE, Wu WC et-al. Radiologic and manometric correlation in "nutcracker esophagus". AJR Am J Roentgenol. 1986;147 (4): 692-5. doi:10.2214/ajr.147.4.692 - Pubmed citation
- 2. Richter J. The Lancet. 2001;358 (9284): . doi:10.1016/S0140-6736(01)05973-6
- 3. Chaudry MA, Thrumurthy SG, Mughal M. Gastric and Oesophageal Surgery (Oxford Specialist Handbooks in Surgery). Oxford University Press. ISBN:0199663203. Read it at Google Books - Find it at Amazon
- 4. Dheer S, Chang R. Images in clinical medicine. "Corkscrew" esophagus. N. Engl. J. Med. 2003;348 (17): 1671. doi:10.1056/NEJMicm020564 - Pubmed citation
- 5. Bredenoord AJ, Fox M, Kahrilas PJ et-al. Chicago classification criteria of esophageal motility disorders defined in high resolution esophageal pressure topography. Neurogastroenterol. Motil. 2012;24 Suppl 1: 57-65. doi:10.1111/j.1365-2982.2011.01834.x - Free text at pubmed - Pubmed citation
- 6. Richter JE. Gastroesophageal Reflux Disease, An issue of Gastroenterology Clinics of North America, (The Clinics: Internal Medicine). Elsevier. ISBN:B00IKUM5TQ. Read it at Google Books - Find it at Amazon
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