Dunedin Hospital, Southern District Health Board, Otago University.
Christchurch Hospital, Canterbury District Health Board.
N Z Med J. 2024 Sep 27;137(1603):143-146. doi: 10.26635/6965.6655.
Respiratory arrest secondary to megaoesophagus is a rare complication of achalasia. We treated an 85-year-old female with a history of achalasia who presented with sudden respiratory arrest and cardiopulmonary resuscitation in the community. In the emergency department, she was intubated for respiratory distress secondary to upper airway obstruction and reduced consciousness. Flexible nasal endoscopy revealed a retropharyngeal bulge, and computed tomography (CT) demonstrated megaoesophagus with distal tapering. She was managed with gastric decompression and percutaneous endoscopic gastrostomy (PEG) feeding with an uncomplicated hospital course. This case provides a rare differential for a patient with acute upper airway obstruction and cardiopulmonary arrest and is the first such case described in the literature in Aotearoa New Zealand.
巨食管导致的呼吸停止是贲门失弛缓症的罕见并发症。我们治疗了一位 85 岁的女性患者，她有贲门失弛缓症病史，在社区突然出现呼吸停止和心肺复苏。在急诊科，她因上呼吸道梗阻和意识降低导致呼吸窘迫而插管。灵活的鼻内窥镜检查显示咽后膨出，计算机断层扫描（CT）显示巨食管伴远端变细。她接受了胃减压和经皮内镜胃造口术（PEG）喂养，住院过程顺利。该病例为急性上呼吸道梗阻和心肺骤停患者提供了一个罕见的鉴别诊断，也是新西兰首例此类病例。
