Mohammed Noufal B

Mohammed Noufal B

Institute of Medical Gastroenterology, Madras Medical College, India

Title: Transient Elastography in Non-cirrhotic Portal Fibrosis: A Comparative Study With Child A Cirrhosis In a Tertiary Care Centre


Mohammed  Noufal B has completed his MBBS and MD internal medicine from The Tamilnadu  Dr MGR Medical University. He is currently pursuing his post graduate course,DM  in medical gastroenterology at  the Madras Medical College Chennai,India.He has published  papers in reputed journals and conducting various research studies.


Introduction: Pneumatic dilation (PD) is considered to be the first line nonsurgical therapy for achalasia. The principle of the procedure is to weaken  the lower  esophageal sphincter by tearing its muscle fibers by generating radial force which is done endoscopically  without fluoroscopic control using  a low-compliance balloon such as  Rigiflex dilator . It has the advantage of determining mucosal injury during the dilation process, so that a repeat endoscopy is not needed to assess the mucosal tearing.

Aim: To study the series of cases of  achalasia  cardia, managed  by pneumatic dilatation and observe their efficacy, outcomes and complications presenting  in our centre during the period of July 2015 to 2017

Methods: 27 cases of achalasia cardia  which presented to our centre during July 2015 to 2017  and  managed by endoscope guided  pneumatic dilatation were retrospectively analysed and their outcomes were observed.

Results: 25 of 27 patients with achalasia presented with dysphagia for solids or liquids. 20 patients had regurgitation and vomiting. Weight loss of more than 5 Kg was observed in 10 patients. History of  nocturnal cough was present in 7 patients. 35 dilatations were performed in 27 patients. All patients had  relief of dysphagia and regurgitation within 24 hours. Barium swallow within a week of dilatation  showed a decrease in the maximum  diameter of the oesophagus from 42.4 + 11.4 mm to 30.5 + 10.5 mm and increase in the diameter of the narrowed lower segment  from 2.45 + 1.5 mm to 11.4+ 2.2 mm. None of the patients  showed a hold up of  barium after dilatation. 20 patients complained of retrosternal  pain during  procedure but none persisted for 24 hours. No perforations were encountered during the study. There was no procedural mortality .

Conclusion: Endoscope-guided PD is an efficient and safe nonsurgical therapy with results comparable to other treatment modalities.