Aydın Ömür, Yüksel Cabir, Tuncalı Timur, Ozkan Murat, Kaya Akın, Ökten Ilker, Mısırlıgil Zeynep
Division of Immunology and Allergy, Department of Chest Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey.
Tuberk Toraks. 2013;61(2):147-51. doi: 10.5578/tt.5778.
Achalasia is characterized by incomplete lower oesophageal sphincter relaxation and aperistalsis of the oesophagus. It may present with dyspnea symptom. An 18-years-old male patient applied to a clinic with the complaints of cough, dyspnea, wheezing and diagnosed as asthma. Although his asthma treatment was increased in time while he did not recover, he was reffered to our hospital with the diagnosis of uncontrolled asthma. On chest X-ray there was a mild upper mediastinal enlargement and chest computed tomography revealed an over-dilated oesophagus constricting the trachea. The patient was referred to chest surgery clinic with a suspected diagnosis of achalasia. Barium-oesophagogram and endoscopic evaluation of the oesophagus confirmed the diagnosis of achalasia. The patient underwent Heller myotomy and oesophagogastrostomy. He was recovered in one week after the surgery without any complaint of dyspnea. Spirometry tests and chest X-ray resulted normal in one year. With this case of achalasia who used asthma treatment unnecessarily,we wanted to emphasize the importance of differential diagnosis of difficult asthma.
贲门失弛缓症的特征是食管下括约肌松弛不完全和食管无蠕动。它可能表现为呼吸困难症状。一名18岁男性患者因咳嗽、呼吸困难、喘息到一家诊所就诊，被诊断为哮喘。尽管他的哮喘治疗及时增加，但病情未恢复，最终以控制不佳的哮喘诊断被转诊至我院。胸部X线显示轻度上纵隔增宽，胸部计算机断层扫描显示食管过度扩张并压迫气管。该患者因疑似贲门失弛缓症被转诊至胸外科诊所。食管钡餐造影和食管内镜评估证实了贲门失弛缓症的诊断。患者接受了贲门肌切开术和食管胃吻合术。术后一周康复，无任何呼吸困难主诉。一年后肺功能测试和胸部X线检查结果正常。通过这个不必要使用哮喘治疗的贲门失弛缓症病例，我们想强调鉴别诊断难治性哮喘的重要性。
