Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

29 October 2015 : Case report  USA

Pseudoachalasia: Still a Tough Clinical Challenge

Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents

Yi JiaABCDEF, Richard W. McCallumADEFG

DOI: 10.12659/AJCR.894444

Am J Case Rep 2015; 16:768-773

Abstract

BACKGROUND: Treatment of achalasia is focused on decreasing the resting lower esophageal sphincter by either pneumatic dilation or surgical myotomy. When patients symptomatically relapse after one or more pneumatic dilations, then one explanation is to consider the possibility of pseudoachalasia as the diagnosis.

CASE REPORT: We present a rare case of an elderly patient with a presentation of chronic dysphagia and severe weight loss, who had diagnostic findings consistent with achalasia, and who also responded very well to a series of pneumatic dilations, but for only brief intervals. Further investigations finally uncovered esophageal adenocarcinoma, thus making our patient an example of the entity “pseudoachalasia”.

CONCLUSIONS: Pseudoachalasia secondary to an esophageal malignancy should be suspected when dysphagia progresses despite technically well-performed pneumatic dilations, and is particularly suspicious in the setting of an elderly patient with marked weight loss. Endoscopic ultrasound is a new diagnostic tool for detecting and staging malignancy by obtaining diagnostic tissue and allowing appropriate therapy to be planned.

Keywords: Aged, 80 and over, Adenocarcinoma - diagnosis, Diagnosis, Differential, Endoscopy, Digestive System, Endosonography, Esophageal Achalasia - etiology, Esophageal Neoplasms - diagnosis

Add Comment 0 Comments

In Press

Case report  Italy

Optimizing Surgical Techniques for Anal Canal Duplications in 2 Pediatric Patients

Am J Case Rep In Press; DOI: 10.12659/AJCR.945747  

Case report  China

A 73-Year-Old Man Presenting with Shoulder Muscle Pain and a Diagnosis of Guillain-Barré Syndrome

Am J Case Rep In Press; DOI: 10.12659/AJCR.945539  

Case report  China

Diagnostic Challenges in Sporadic Creutzfeldt-Jakob Disease: A Case Study of Typical Clinical Presentation ...

Am J Case Rep In Press; DOI: 10.12659/AJCR.945795  

Case report  China

Minimally Invasive Management of Infantile Dacryocystitis with Lacrimal Abscess: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.946588  

Most Viewed Current Articles

21 Jun 2024 : Case report  China (mainland) 88,518

Intracranial Parasitic Fetus in a Living Infant: A Case Study with Surgical Intervention and Prognosis Anal...

DOI :10.12659/AJCR.944371

Am J Case Rep 2024; 25:e944371

0:00

07 Mar 2024 : Case report  USA 50,005

Neurocysticercosis Presenting as Migraine in the United States

DOI :10.12659/AJCR.943133

Am J Case Rep 2024; 25:e943133

0:00

20 Nov 2023 : Case report  Saudi Arabia 25,154

Azithromycin Treatment for Acne Vulgaris: A Case Report on the Risk of Clostridioides difficile Infection

DOI :10.12659/AJCR.941424

Am J Case Rep 2023; 24:e941424

0:00

18 Feb 2024 : Case report  Japan 22,640

A Case of Thoracic Empyema Caused by Actinomyces naeslundii

DOI :10.12659/AJCR.943030

Am J Case Rep 2024; 25:e943030

0:00

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923