Yu Wen-Quan, Gao Hui-Jiang, Zhai Li-Xue, Wei Yu-Cheng
Department of Thoracic Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.
Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Shinan District, Qingdao, Shandong Province, China.
J Cardiothorac Surg. 2024 Apr 15;19(1):214. doi: 10.1186/s13019-024-02688-w.
Pseudoachalasia is a rare disease that behaves similarly to achalasia (AC), making it sometimes difficult to differentiate.
We report a case of 49-year-old male with adenocarcinoma of the gastroesophageal junction misdiagnosed as achalasia. No obvious abnormalities were found in his initial examinations including upper digestive endoscopy, upper gastrointestinal imaging and chest computed tomography (CT). During the subsequent introduced-peroral endoscopic myotomy (POEM), it was found that the mucosal layer and the muscular layer had severe adhesion, which did not receive much attention, delayed the clear diagnosis and effect treatment, and ultimately led to a poor prognosis for the patient.
This case suggests that when patients with AC found mucosal and muscular adhesions during POEM surgery, the possibility should be considered that the lesion may be caused by a malignant lesion.
假性贲门失弛缓症是一种罕见疾病，其表现与贲门失弛缓症（AC）相似，有时难以鉴别。
我们报告一例49岁男性，其胃食管交界腺癌被误诊为贲门失弛缓症。其初始检查包括上消化道内镜检查、上消化道造影和胸部计算机断层扫描（CT）均未发现明显异常。在随后进行的经口内镜下肌切开术（POEM）中，发现黏膜层与肌层有严重粘连，当时未引起足够重视，延误了明确诊断和有效治疗，最终导致患者预后不良。
该病例提示，对于贲门失弛缓症患者，若在POEM手术中发现黏膜与肌层粘连，应考虑病变可能由恶性病变引起。
