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- W2912682668 abstract "We are presenting a unique case of achalasia of primary idiopathic etiology mimicking Pseudoachalasia. A 50 Year old Hispanic female presented to our GI clinic with severe complains of dysphgaia to both solids and liquids and regurgitation for past 4 weeks. It has gotten worse over the past few days now associated nausea, vomiting and 15 pounds of weight loss. In her last three ER vists in the last 4 weeks, she was diagnosed as GERD and treated with PPI, Sucralfate and antiemetics. She denied any significant pertinent past medical and surgical history. Her vital signs and physical examination were unremarkable. She was admitted for the evalaution of worsening Dysphagia. Endoscopic Gastroduodenoscopy was done, which revealed moderately diffuse dilation of the body of the esophagus with semi solid food coating of the mucosa. The endoscope met mild resistance while crossing the gastroesophageal junction into the stomach. The CT Chest reported negative for intrathorasic masses, but displayed dilated and asymmetric mural thickening of esophagus. With gastric fundus adenocarcinoma and esophageal cancer ruled out on EGD and CT Chest and keeping in mind the atypical presentation of this achalasia; we ordered Endoscopic Ultrasonography-EUS to rule out intrathoracic or intraabdominal neoplasms in and around the lower esophageal sphincter. EUS rulled out Intraluminal or Extraluminal GE junctional masses or Paraesophageal lymphadenopathy. However non-appreciable esophageal motility and a hypertonic lower esophageal sphincter was observed. Our suspicion for idiopathic achalasia was thus enhanced, which was confirmed on Esophageal Motility study. She was reffered to Surgery for Heller's myotomy. It is well known that achalasia is a chronic disease that starts gradually and worsens with increasing dysphagia over time. On the contrary, Pseudoachalasia is a term used to define a malignant neoplasm or stricture arising from the lower esophagus or upper stomach invading the esophageal lumen or nerve plexus. Our patient at first glance was thought to be a case of pseudoachalasia (malignancy causing achalasia). However as evident by all our extensive investigations we were quite surprisingly dealing with Primary idiopathic achalasia with atypical acute onset." @default.
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- W2912682668 date "2017-10-01" @default.
- W2912682668 modified "2023-10-18" @default.
- W2912682668 title "Acute Onset Dysphagia: An Atypical Presentation of Idiopathic Achalasia" @default.
- W2912682668 doi "https://doi.org/10.14309/00000434-201710001-01733" @default.
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