Korean J Gastroenterol.  2019 Feb;73(2):105-108. 10.4166/kjg.2019.73.2.105.

Achalasia Cardia Resulting in Bronchial Obstruction: A Case Series and Literature Review

• Then EO
• Sunkara T
• John F
• Dewnani KK
• Culliford
• Gaduputi V

• KMID: 2438710
• DOI: http://doi.org/10.4166/kjg.2019.73.2.105

Abstract

Achalasia is a motility disorder of the esophagus that is characterized by loss of ganglionic neurons within the myenteric plexus of the lower esophageal sphincter (LES) resulting in failure of the LES to relax. Clinically this disorder presents with simultaneous dysphagia to solids and liquids, and if left untreated, leads to esophageal dilation, which can give rise to many adverse consequences. Extrinsic compression of respiratory structures is one such consequence, and rarely, cases of tracheal compression secondary to achalasia have been reported. However, cases of extrinsic bronchial compression are yet rarer. Here, we present a case series comprised of two patients with achalasia who presented with extrinsic bronchial compression by a dilated esophagus secondary to achalasia.

Keyword

Esophageal achalasia; Dysphagia; Airway obstruction; Heller myotomy; Esophageal motility disorders

MeSH Terms

Airway Obstruction
Cardia*
Deglutition Disorders
Esophageal Achalasia*
Esophageal Motility Disorders
Esophageal Sphincter, Lower
Esophagus
Ganglion Cysts
Humans
Myenteric Plexus
Neurons

Figure

• 

  Fig. 1 Upper endoscopy showing dilated esophagus containing food.

• 

  Fig. 2 CT image scan of the chest showing a dilated esophagus resulting in compressed right main stem bronchus (arrow) intermedius. CT, computed tomography.

• 

  Fig. 3 Chest CT image (axial view) showing a severely dilated esophagus measuring up to 7.4×7.8 cm in diameter and occlusion of the right middle lobe bronchus (arrows) secondary to the mass effect of the dilated esophagus. CT, computed tomography.

• 

  Fig. 4 Chest CT image (sagittal and coronal respectively) showing a severely dilated esophagus. CT, computed tomography.

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