Author:
Yu Wen-Quan,Gao Hui-Jiang,Zhai Li-Xue,Wei Yu-Cheng
Abstract
Abstract
Background
Pseudoachalasia is a rare disease that behaves similarly to achalasia (AC), making it sometimes difficult to differentiate.
Case presentation
We report a case of 49-year-old male with adenocarcinoma of the gastroesophageal junction misdiagnosed as achalasia. No obvious abnormalities were found in his initial examinations including upper digestive endoscopy, upper gastrointestinal imaging and chest computed tomography (CT). During the subsequent introduced-peroral endoscopic myotomy (POEM), it was found that the mucosal layer and the muscular layer had severe adhesion, which did not receive much attention, delayed the clear diagnosis and effect treatment, and ultimately led to a poor prognosis for the patient.
Conclusions
This case suggests that when patients with AC found mucosal and muscular adhesions during POEM surgery, the possibility should be considered that the lesion may be caused by a malignant lesion.
Publisher
Springer Science and Business Media LLC
Reference13 articles.
1. Pandolfino JE, Gawron AJ. Achalasia: a systematic review. JAMA. 2015;313:1841–52.
2. Vaezi MF, Pandolfino JE, Yadlapati RH, Greer KB, Kavitt RT. ACG clinical guidelines: diagnosis and management of Achalasia. Am J Gastroenterol. 2020;115:1393–411.
3. Francis DL, Katzka DA. Achalasia: update on the disease and its treatment. Gastroenterology. 2010;139:369–74.
4. Zaninotto G, Bennett C, Boeckxstaens G, Costantini M, Ferguson MK, Pandolfino JE et al. The 2018 ISDE achalasia guidelines. Dis Esophagus: Official J Int Soc Dis Esophagus 2018;31.
5. Ponds FA, van Raath MI, Mohamed SMM, Smout A, Bredenoord AJ. Diagnostic features of malignancy-associated pseudoachalasia. Aliment Pharmacol Ther. 2017;45:1449–58.