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Related Experiment Videos

Achalasia presenting as acute stridor

S P Dunlop1, S P Travis

  • 1Gastroenterology Unit, Derriford Hospital, Plymouth, UK.

European Journal of Gastroenterology & Hepatology
|February 12, 1998
PubMed
Summary

Achalasia can cause a mega-oesophagus leading to severe airway obstruction. Urgent naso-oesophageal decompression is a life-saving intervention for this rare but critical complication.

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Area of Science:

  • Gastroenterology
  • Pulmonology
  • Otolaryngology

Background:

  • Achalasia is a rare esophageal motility disorder.
  • Mega-oesophagus, a severe dilation of the esophagus, can occur secondary to achalasia.
  • Tracheal compression is a rare but life-threatening complication of mega-oesophagus.

Observation:

  • An 87-year-old woman presented with acute stridor and respiratory distress.
  • Clinical examination and imaging revealed a mega-oesophagus causing tracheal compression.
  • The patient's symptoms were attributed to this rare presentation of achalasia.

Findings:

  • Nasooesophageal decompression by aspiration effectively relieved the airway obstruction.
  • Barium swallow confirmed mega-oesophagus secondary to achalasia compressing the trachea.
  • A review of 28 previous cases highlights the rarity and severity of this condition.

Implications:

  • Early recognition of tracheal compression in achalasia is crucial.
  • Nasooesophageal decompression offers a vital, potentially life-saving treatment.
  • This case underscores the importance of considering esophageal causes for respiratory distress in the elderly.

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