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Early Phase of Achalasia Manifested as an Esophageal Subepithelial Tumor / 대한소화기병학회잡지
Korean Journal of Gastroenterology ; : 110-114, 2019.
Article in English | WPRIM | ID: wpr-761534
ABSTRACT
The Chicago classification (CC) defines an esophagogastric junction outflow obstruction (EGJOO) as the presence of several instances of intact or weak peristalsis, elevated median integrated relaxation pressure above 15 mmHg, and a discrepancy from the criteria of achalasia. The revised CC addresses the potential etiology of EGJOO, including the early forms of achalasia, mechanical obstruction, esophageal wall stiffness, or manifestation of hiatal hernia. A 58-year-old woman visited the Presbyterian Medical Center with swallowing difficulty. The patient underwent a high resolution manometry (HRM) examination and was diagnosed with EGJOO. Chest CT was performed to exclude a mechanical obstruction as a cause, and CT revealed a subepithelial tumor (SET) at the upper part of the esophagogastric junction. Therefore, laparoscopic surgery was performed and eccentric muscular hypertrophy of the distal esophagus was observed. Longitudinal myotomy and Dor fundoplication were also performed. The histology findings of the surgical specimens were consistent with achalasia. This paper reports a case of early achalasia that was finally diagnosed by the histology findings, but was initially diagnosed as EGJOO using HRM and misdiagnosed as SET in the image study.
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Full text: Available Index: WPRIM (Western Pacific) Main subject: Peristalsis / Relaxation / Esophageal Achalasia / Tomography, X-Ray Computed / Classification / Laparoscopy / Fundoplication / Deglutition / Protestantism / Esophagogastric Junction Limits: Female / Humans Language: English Journal: Korean Journal of Gastroenterology Year: 2019 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Peristalsis / Relaxation / Esophageal Achalasia / Tomography, X-Ray Computed / Classification / Laparoscopy / Fundoplication / Deglutition / Protestantism / Esophagogastric Junction Limits: Female / Humans Language: English Journal: Korean Journal of Gastroenterology Year: 2019 Type: Article