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Diffuse Spasm of the Lower Part of the Esophagus:  Fine Structure of Esophageal Smooth Muscle and Nerve

Robert R. Cassella, MD; F. Henry Ellis Jr., MD; Arnold L. Brown Jr., MD
JAMA. 1965;191(5):379-382. doi:10.1001/jama.1965.03080050025006.
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Diffuse spasm of the esophagus is a disturbance characterized by hypermotility in which powerful, sometimes repetitive, incoordinated contractions of the lower part of the esophagus occur in response to deglutition.1 Clinically, pain is the predominant symptom. Pain occasionally is brought on by eating but more often comes on spontaneously. Dysphagia alone is uncommon.

The cause of diffuse esophageal spasm is unknown and the pathological features have been investigated only rarely. The only recent pathological study of which we are aware is by Byrnes.2 His findings suggested that an error in "muscular cell contact" is responsible for this disease.

The present study was undertaken to define further the fine structural changes in both smooth muscle and vagus nerve in the region of the lower part of the esophagus in patients with diffuse esophageal spasm.

Methods  Six patients were included in the study. The clinical diagnosis was established from the history and from esophagoscopic and roentgenologic study.


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