Carvalho Lucia, Guimarães Marta, Pereira Ana Marta, Almeida Rui F, Nora Mário
General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, PRT.
Cureus. 2020 Dec 29;12(12):e12351. doi: 10.7759/cureus.12351.
Achalasia is a rare primary disorder of esophageal motility characterized by insufficient lower esophageal sphincter relaxation and loss of esophageal peristalsis. This results in patient complaints of dysphagia to solids and liquids, regurgitation, chest pain, and weight loss. However, achalasia may also present with respiratory symptoms, such as aspiration pneumonia, due to remarkable regurgitation. In untreated patients and a long period of evolution, respiratory symptoms may even be the initial manifestation of achalasia. An endoscopic finding of retained food and saliva with a puckered gastroesophageal junction or barium swallow showing dilated esophagus with birds beaking in a symptomatic patient should prompt appropriate diagnostic and therapeutic strategies. We describe an atypical presentation of a rare disease in a young man with a history of symptoms caused by the late manifestation of achalasia.
贲门失弛缓症是一种罕见的食管动力原发性疾病，其特征为食管下括约肌松弛不足和食管蠕动丧失。这导致患者出现吞咽固体和液体困难、反流、胸痛及体重减轻等症状。然而，由于显著的反流，贲门失弛缓症也可能表现出呼吸道症状，如吸入性肺炎。在未经治疗的患者以及疾病长期进展过程中，呼吸道症状甚至可能是贲门失弛缓症的初始表现。对于有症状的患者，内镜检查发现食管内有残留食物和唾液，且胃食管交界处有褶皱，或钡餐检查显示食管扩张并有鸟嘴样改变，应促使采取适当的诊断和治疗策略。我们描述了一名年轻男性罕见疾病的非典型表现，该患者有因贲门失弛缓症晚期表现引起的症状病史。
