Delayed diagnosis and treatment of achalasia: a case report.

IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Journal of Medical Case Reports Pub Date : 2024-10-15 DOI:10.1186/s13256-024-04717-7
Sabrina Ginsburg, Chelsea Caplan, Gauri Agarwal
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Abstract

Background: Achalasia is characterized as an esophageal motility disorder with incomplete relaxation of the lower esophageal sphincter. Achalasia can be associated with abnormal peristalsis and symptoms of dysphagia, acid reflux, and chest pain. The exact pathophysiology of achalasia remains unclear, but it is hypothesized to be due to degeneration of the myenteric plexus.

Case presentation: In this case, a 46-year-old Hispanic man presented to the emergency room with a 12-year history of progressive discomfort with swallowing solids and liquids. Due to many years of incomplete follow-up care and lack of understanding of the course of his disease, this patient's symptoms escalated to complete intolerance of oral intake and significant weight loss. He was diagnosed with achalasia during his hospital stay and treated successfully with laparoscopic Heller myotomy.

Conclusions: This case discussion illustrates the importance of follow-up care and patient education so that diagnosis and treatment of achalasia are not delayed.

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贲门失弛缓症的延迟诊断和治疗:病例报告。
背景:Achalasia 是一种食管运动障碍,表现为食管下括约肌不完全松弛。贲门失弛缓症可伴有异常蠕动以及吞咽困难、反酸和胸痛等症状。贲门失弛缓症的确切病理生理学尚不清楚,但推测是由于肠肌丛变性所致:在本病例中,一名 46 岁的西班牙裔男子因吞咽固体和液体时逐渐感到不适而到急诊室就诊,病史长达 12 年。由于多年未接受完整的后续治疗,加上对自己的病程缺乏了解,这名患者的症状升级为完全无法忍受口腔摄入,体重明显下降。住院期间,他被诊断为贲门失弛缓症,并成功接受了腹腔镜海勒肌切开术:本病例讨论说明了随访护理和患者教育的重要性,从而避免延误贲门失弛缓症的诊断和治疗。
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来源期刊
Journal of Medical Case Reports
Journal of Medical Case Reports Medicine-Medicine (all)
CiteScore
1.50
自引率
0.00%
发文量
436
期刊介绍: JMCR is an open access, peer-reviewed online journal that will consider any original case report that expands the field of general medical knowledge. Reports should show one of the following: 1. Unreported or unusual side effects or adverse interactions involving medications 2. Unexpected or unusual presentations of a disease 3. New associations or variations in disease processes 4. Presentations, diagnoses and/or management of new and emerging diseases 5. An unexpected association between diseases or symptoms 6. An unexpected event in the course of observing or treating a patient 7. Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
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