Lakhan Shaheen E, Kumar S Jeevan, Kini P Ratnakar
Global Neuroscience Initiative Foundation, Los Angeles, CA, USA.
J Med Case Rep. 2008 Dec 13;2:383. doi: 10.1186/1752-1947-2-383.
Achalasia cardia is characterized by failure of the lower esophageal sphincter to relax in response to swallowing and by an absence of peristalsis in the esophageal body. Absence of a gastric air bubble is a well known radiological finding. Pneumatic balloon dilatation results in reappearance of the gastric bubble.
We report the case of a 43-year-old Indian man with achalasia cardia whose chest X-ray at the time of presentation showed an air bubble in the gastric region causing a diagnostic quandary. Successful dilatation of the lower esophageal sphincter resulted in the appearance of another air bubble in the gastric region. Proper analysis showed that the first bubble was actually a colonic air bubble of the splenic flexure and the appearance of the second bubble was the anticipated gastric air bubble.
In patients presenting with achalasia cardia, a colonic air bubble may be seen in the gastric region causing diagnostic difficulty. In these patients, a gastric air bubble may appear after pneumatic dilatation. At the end of the procedure, there will be two air bubbles ("double bubble"): a colonic and a gastric air bubble. To our knowledge, this finding has not been reported in the literature thus far.
贲门失弛缓症的特征是食管下括约肌在吞咽时不能松弛，且食管体部无蠕动。胃内无气泡是一种众所周知的放射学表现。气囊扩张可使胃气泡重新出现。
我们报告一例43岁患有贲门失弛缓症的印度男性病例，其就诊时的胸部X线片显示胃区有气泡，造成诊断上的困惑。食管下括约肌成功扩张后，胃区出现了另一个气泡。经适当分析表明，第一个气泡实际上是脾曲的结肠气泡，第二个气泡的出现才是预期的胃气泡。
在患有贲门失弛缓症的患者中，胃区可能会出现结肠气泡，导致诊断困难。在这些患者中，气囊扩张后可能会出现胃气泡。在操作结束时，会有两个气泡（“双泡”）：一个结肠气泡和一个胃气泡。据我们所知，这一发现迄今尚未在文献中报道。
