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Manometrically jackhammer esophagus with fluoroscopically/endoscopically distal esophageal spasm: a case report
Apichet Sirinawasatien1, Pallop Sakulthongthawin2
1Division of Gastroenterology, Department of Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, 2, Phayathai Road, Rajathewi, Bangkok, 10400, Thailand. sui_apichet@yahoo.com.
Background:
Jackhammer esophagus is a rare esophageal motility disorder that can result in dysphagia, chest pain, and gastro-esophageal reflux symptoms. High-resolution manometry is the gold standard for diagnosis, while corkscrew esophagus on upper gastrointestinal endoscopy is an uncommon manifestation.
Case Presentation:
72-year-old man who presented with progressive dysphagia for three months without symptoms of chest pain or heartburn. Initial workup showed a corkscrew esophagus on upper gastrointestinal endoscopy; subsequently, high-resolution manometry revealed an esophago-gastric junction outflow obstruction with hypercontractile (jackhammer) esophagus. Treatment with calcium channel blockers and proton pump inhibitors was successful and relieved his symptoms near completion.
Conclusions:
Even though the corkscrew esophagus is typically for distal esophageal spasm, the hypercontractile (jackhammer) esophagus can appear. The high-resolution manometry can help to distinguish each specific motility disorder.
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