[The esophagus in patients with Chagas disease in Córdoba, Argentina. Histologico-immunohistochemical, and evacuation time].

Rev Fac Cien Med Univ Nac Cordoba

Instituto de Biologia Celular, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba.

Published: July 2000

Unlabelled: With the purpose of to establish the status of the oesophagus with respect to chagasic aendemia in subjects of the central rural zone of Argentine, we search the esophagic evacuation duration-time by means of a radiologic standardized test which studied the ingested barium transit as well us the caliber of a given oesophagus. 87 chagasic subjects from rural zones of Cordoba and Santiago del Estero, Argentina, were studied. All had several positive serological test for Chagas' infection. As controls 120 similar studies performed in subjects with negative serological tests for Chagas were considered. Besides, an histopathologic study on samples of oesophagus of four cases of chagasic patients deceased by different causes, and selected at random were performed, regarding the plexus of Auerbach and the muscle layers.

Results: 63% of chagasic subjects showed lengthening of esophagic evacuation; 35% of these referred some symptoms of oesophagic disfunctionalism. However, most of the cases corresponded to Group I of the Rezende's classification, that is, with normal caliber of oesophagus with slow transit and retention of barium. Only 3 cases were of group II. The histopathologic study showed diminution of the size and the number of neural structures of the Auerbach plexus as well as of the number of the neurone cells; in all they there were moderate infiltration by T-lymphocytes. In some areas there were replacement of neural structures by fibrosis.

Conclusions: The analysis of results by age groups, showed that abnormal peristalsis of the oesophagus was present since the early ages of chagasic subjects, and affected a growing number in adult and elderly groups. Great megaesophagus were infrequent in these chagasic, suggesting that in the production of Groups III and IV of chagasic megaesophagus, that are frequent in other regions of South America, could intervene other factors.

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