Flook D, Stoddard C J
Eur J Surg Oncol. 1987 Jun;13(3):213-7.
Malignancy involving the gastro-oesophageal junction can present with features very similar to those of idiopathic achalasia. Failure to identify such cases may delay effective treatment of a curable tumour. We report four patients with malignant dysphagia who were initially referred for treatment of achalasia--the diagnosis based on clinical, radiographic and endoscopic findings in each case. In all four, oesophageal manometry suggested, correctly, that the diagnosis of achalasia was incorrect, allowing early surgical exploration. We suggest that the diagnosis of achalasia should be confirmed by manometric studies--particularly in elderly patients with a short history and weight loss as these features are frequently associated with malignancy.
累及胃食管交界的恶性肿瘤可能表现出与特发性贲门失弛缓症非常相似的特征。未能识别此类病例可能会延误可治愈肿瘤的有效治疗。我们报告了4例最初因贲门失弛缓症转诊接受治疗的恶性吞咽困难患者——每例均根据临床、影像学和内镜检查结果做出诊断。在所有4例患者中，食管测压正确地提示贲门失弛缓症的诊断有误，从而得以早期进行手术探查。我们建议贲门失弛缓症的诊断应通过测压研究来证实——尤其是对于病史较短且体重减轻的老年患者，因为这些特征常与恶性肿瘤相关。
