[Dysphagia and Sonography: what Association?]

Area of Science:

• Gastroenterology and Internal Medicine
• Esophageal Motility Disorders

Background:

• Achalasia is a primary esophageal motility disorder.
• Symptoms include dysphagia, chest pain, and refractory reflux.
• Accurate diagnosis relies on detailed patient history and esophageal manometry.

Purpose of the Study:

• To present a challenging case of achalasia misdiagnosis.
• To underscore the significance of clinical skills in diagnosis.
• To highlight the utility of ultrasonography in internal medicine.

Main Methods:

• Case report of a 31-year-old woman with prolonged misdiagnosis.
• Clinical evaluation including patient-physician interaction and bedside assessment.
• Utilized ultrasonography as part of the diagnostic process.

Main Results:

• The patient presented with typical achalasia symptoms but had a complex history leading to delayed diagnosis.
• The case emphasizes that fundamental clinical skills remain crucial despite medical advancements.
• Ultrasonography proved to be a valuable, simple tool for comprehensive evaluation.

Conclusions:

• Misdiagnosis of achalasia can occur due to complex patient histories.
• The patient-physician relationship and bedside approach are paramount for accurate diagnosis.
• Ultrasonography is a valuable adjunct in general internal medicine for evaluating such conditions.