Revista da Sociedade Brasileira de Medicina Tropical
Print version ISSN 0037-8682
RASSI, Anis and REZENDE, Joffre Marcondes de. Clinical and radiological evaluation of the esophagus and colon in the acute phase of Chagas disease with Report of three cases of spontaneous remission of esophageal group I aperistalsis. Rev. Soc. Bras. Med. Trop. [online]. 2011, vol.44, n.1, pp.70-75. ISSN 0037-8682. http://dx.doi.org/10.1590/S0037-86822011000100016.
INTRODUCTION: The esophagus and colons of patients with acute Chagas disease were studied. METHODS: Deglutition and radiological examination of the esophagus were assessed in 94 (90.4%) patients, 10 children were excluded due to their age. Intestinal transit was assessed in 59 (56.7%) patients. RESULTS: Deglutition was normal in 86 (91.5%) patients, 5 of whom presented aperistalsis (group I). Incipient dysphagia was reported by 8 patients, 7 of whom normal barium swallowing, while only one presented esophageal aperistalsis (group I). A second radiological examination of the esophagus was performed in 4 of the 6 cases with aperistalsis 6 months after the initial test. It was normal in 3, and showed aperistalsis in one case, the only patient who was treated with benznidazole and considered cured of the infection. Intestinal transit was normal in 96 (92.3%) patients, constipated in 7 (6.7%), and diarrheic in one (1%). Barium enema was normal in 54/59 (91.5%), showed a dolichosigmoid in 4 (6.8%) and a dolichorectomegasigmoid in one (1.7%), of functional origin, according to the electromanometric results. CONCLUSIONS: To explain the regression of aperistalsis, 2 non-excluding hypothesis were postulated: the intramural inflammatory process, established during the acute phase, could interfere with esophageal motility by weakening the peristaltic waves; with the remission of the inflammatory reaction, the peristaltic activity of the esophagus would return to normal, as long as no extensive denervation occurred; and/or a definitive reinnervation is responsible for the recuperation of the normal esophageal peristaltic activity.
Keywords : Chagas disease; Acute phase; Esophagus and colon.