| Background: The aim of this study was to identify novel endoscopic features in patients with achalasia diagnosed by HRM with no “esophageal rosette". Methods: Ten patients were diagnosed with achalasia after performing HRM with no “esophageal rosette” on endoscopy. Age/ gender-matched healthy volunteers (HVs) were also enrolled. Following the diagnosis of achalasia, endoscopic findings of the lower esophagus, including narrowing, “esophageal rosette”, and shape and morphology in the longitudinal plane, were examined retrospectively. In addition, images were evaluated as to whether the overall structure of the esophageal palisade vessels (PVs), including the lower margin of the PVs, could be identified. Results: “Esophageal rosette” was not observed in any of the achalasia patients or HVs. The overall structure of the PVs, including its lower margin, was observed in all HVs. However, we were unable to observe the lower margin of the PVs in all patients with achalasia, but the overall structure of the PVs was visible. Stenosis in the lower esophagus was apparent in all achalasia patients, but not in the HVs. Regarding the shape of the lower esophagus in the longitudinal plane, the lower esophagus in all HVs formed a U shape. On the other hand, the lower esophagus in all achalasia patients formed a “gingko leaf” shape. Conclusion: The characteristic endoscopic finding for achalasia patients with no “esophageal rosette" was an unidentifiable lower PV margin. In addition, the lower esophagus in these patients had a “gingko leaf” shape in the longitudinal plane under deep inspiration. |
