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Pseudoachalasia presenting 20 years after Nissen fundoplication: a case report.
- Source :
-
Journal of cardiothoracic surgery [J Cardiothorac Surg] 2016 Jul 07; Vol. 11 (1), pp. 96. Date of Electronic Publication: 2016 Jul 07. - Publication Year :
- 2016
-
Abstract
- Background: Pseudoachalasia is a rare diagnosis manifested by clinical and physiologic symptoms of achalasia, with alternative etiology for outflow obstruction. While malignancy is a frequent cause of pseudoachalasia, prior surgical intervention especially surgery involving the esophagogastric junction, may result in a misdiagnosis of achalasia.<br />Case Presentation: We present a case of a 70 year-old male with dysphagia and weight loss after undergoing a Billroth I and Nissen fundoplication several decades ago. His preoperative studies suggested achalasia and he was therefore referred for an endoscopic myotomy. However, careful interpretation of all the data and intra-operative findings revealed a classic mechanical and functional obstruction requiring takedown of his prior wrap.<br />Conclusions: Individualized interpretation of preoperative studies in the setting of prior foregut surgery is critical to appropriate diagnosis and intervention. This case highlights the significance of endoscopic findings and features of high-resolution manometry specific to pseudoachalasia, which contrasts with classical features of achalasia.
- Subjects :
- Aged
Deglutition Disorders diagnosis
Deglutition Disorders surgery
Esophagogastric Junction surgery
Esophagoscopy
Humans
Male
Manometry
Postoperative Complications diagnosis
Postoperative Complications surgery
Time Factors
Weight Loss
Deglutition Disorders etiology
Fundoplication adverse effects
Gastroenterostomy adverse effects
Postoperative Complications etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1749-8090
- Volume :
- 11
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of cardiothoracic surgery
- Publication Type :
- Academic Journal
- Accession number :
- 27387670
- Full Text :
- https://doi.org/10.1186/s13019-016-0495-y