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Achalasia cardia (kardiospazm) Achalasia cardia - the neuro-muscular disease of the esophagus, characterized by a difficult passage of food from the esophagus into the stomach due to the lack of a reflex of simultaneous disclosure of the cardia in swallowing. Etiology Dysfunction of the gastric cardia in swallowing and passage of food through the esophagus may be associated with the following factors: • Congenital malformation of the nervous system; • Constitutional nevrosteniya discoordination with neurogenic esophageal motility; • Infectious and toxic damage of the nerve plexus of the esophagus and cardia. Predisposing conditions: • Long-term vitamin deficiencies; • Persistent emotional stress • malnutrition The pathogenesis of achalasia cardia  Congenital absence, degeneration or disintegration of a number of ganglion cells auerbahovskogo plexus.  Violation of the innervation of the esophagus, the muscular dystrophy of the apparatus  cardiac muscle spasm of the esophagus  cardiac muscle degeneration Scarring of the esophagus Achalasia cardia Clinic  Dysphagia (difficulty in the passage of food through the esophagus - swallowing disorder)  regurgitation ("esophageal vomiting" - throwing food eaten in the mouth): a common, neobilnaya may occur after a few mouthfuls of food, in other cases it is a rare and very abundant. Regurgitation provokes body position. Night regurgitation (a symptom of wet pads) is associated with relaxation of tone pharyngoesophageal sphincter.  Pain behind the sternum, they are of different nature: - Spasm of the muscles of the esophagus; - An overflow of the esophagus (esophageal wall tension); - Esophagitis.  Methods A. Radiography of the esophagus Two. Esophagoscopy Three. Ezofagomanometriya 4. Ezofagokimografiya  Stages of Development kardiospazma (BV Petrovsky). Stage I - early (initial), a functional intermittent spasm of the esophagus, the lumen of his little extended. Stage II - a constant spasm of the cardia, the esophagus is often extended

3. Kardiodilyatatsiya (stretching cardia of the esophagus) 2.cut sclerosed muscle fibers of the restriction to the submucosal layer of the second). Surgery.1. Treatment A.pronounced stenosis of the cardia. Physiotherapy Two. Vitamin 1. Operation Geller (ezofagokardiomiotomiya .jerk absent disclosure of the cardia. Conservative 1. the esophagus greatly expanded with atonic-walled.3. Antispasmodics 1. scarring of the muscles of the esophagus cardia with marked expansion of its lumen.1. Kardiodilyatator air.4. Three. Nitrates 1.1.shaped. Kardiodilyatator hydrostatic 2.3.Stage III . often S .anastomosis between the expanded part of esophagus and stomach down).5. 3.3.2. 3. Kardiodilyatator Starke (metal construction) 2. . Stage IV .2. Ryumpelya operation (resection of the narrowed area of the esophagus with the imposition of esophagogastric anastomosis). Sedatives 1.2. Operation Heyrovsky (ezofagofundoanastomoz .