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Query: UMLS:C0014848 (achalasia)
 2,804 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Achalasia is a primary motor disorder of the esophagus characterized by insufficient lower esophageal sphincter relaxation and loss of esophageal peristalsis. This results in patients' complaints of dysphagia to solids and liquids, regurgitation, and occasional chest pain with or without weight loss. Endoscopic finding of retained saliva with puckered gastroesophageal junction or barium swallow showing dilated esophagus with birds beaking in a symptomatic patient should prompt appropriate diagnostic and therapeutic strategies. In this ACG guideline the authors present an evidence-based approach in patients with achalasia based on a comprehensive review of the pertinent evidence and examination of relevant published data.
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PMID:ACG clinical guideline: diagnosis and management of achalasia. 2424 18

Per-oral endoscopic myotomy (POEM) was developed less than a decade ago for the treatment of achalasia. Its minimally invasive approach and the favorable short-term outcome have led to rapid adoption of the technique throughout the world. As with any new technique, there will be adverse events, and it is important that effective treatments for these adverse events be discussed. We present a case of successful endoscopic management of an intramural sinus leak after a POEM procedure using tandem fully covered esophageal stents.
ACG Case Rep J 2016 Aug
PMID:Endoscopic Management of an Intramural Sinus Leak After Per- Oral Endoscopic Myotomy. 2792 Oct 57

Botulism toxin injection (BTI) is a well-known and relatively safe endoscopic treatment for achalasia. We report a case of a 90-year-old female diagnosed with achalasia who subsequently underwent BTI with symptomatic relief. The therapy was complicated by systemic botulism, however, leading to progressive muscle paralysis with diaphragmatic involvement requiring mechanical ventilation support. This is the first reported case of BTI for achalasia causing systemic botulism.
ACG Case Rep J 2016 Aug
PMID:Rapidly Progressive Muscle Paralysis and Acute Respiratory Failure Following Endoscopic Botulinum Toxin Injection. 2792 Oct 65

The clinical significance of minor esophageal motility disorders is unclear, though they typically carry a benign course. Distal esophageal spasm progressing to achalasia has been reported, although it appears to be rare. We report a case of a patient with dysphagia and chest pain who was found to have ineffective esophageal motility on high-resolution manometry, which developed into distal esophageal spasm and then progressed to type III achalasia.
ACG Case Rep J 2016 Aug
PMID:Ineffective Esophageal Motility Progressing into Distal Esophageal Spasm and Then Type III Achalasia. 2811 34

Achalasia is a disorder of the esophagus characterized by decreased lower esophageal sphincter (LES) relaxation and absence of esophageal peristalsis. Botulinum toxin (BT) injection targeting the LES has been used in the treatment of achalasia and other esophageal motility disorders, and it is considered to be safe and effective for short-term symptomatic relief. Serious adverse events of this procedure are rare. We report the case of an 83-year-old woman treated with BT injection for achalasia who subsequently developed a subdiaphragmatic abscess.
ACG Case Rep J 2017
PMID:A Case of Sub-Diaphragmatic Abscess after Injection of Botulinum Toxin to Treat Achalasia. 2920 30

Per-oral endoscopic myotomy (POEM) is a relatively novel endoscopic technique for the treatment of achalasia. POEM has been shown to have outcomes comparable to those with Heller myotomy, but it is less invasive and has fewer complications. A 72-year-old man with progressive solid and liquid dysphagia underwent POEM, but soon after the procedure went into cardiac arrest; spontaneous circulation returned after 10 minutes of CPR. He was subsequently found to have tension pneumopericardium as a result of the inadvertent use of air instead of carbon dioxide during the procedure. He had a prolonged hospitalization that required an extended stay in the medical intensive care unit. Although rare, POEM can lead to critical, life-threatening complications.
ACG Case Rep J 2018
PMID:Pneumopericardium Complicating Per-Oral Endoscopic Myotomy Due to Inadvertent Use of Air Instead of Carbon Dioxide. 3014 82

Achalasia is an esophageal motility disorder of impaired lower esophageal sphincter relaxation and absent peristalsis. The presenting symptoms are commonly dysphagia, chest pain, regurgitation, and weight loss. Hiccups have been associated with gastrointestinal diseases but uncommonly associated with achalasia. We present a 62-year-old man with a history of dysphagia, weight loss, and intractable hiccups. High-resolution impedance manometry revealed Type I achalasia, which was treated with per oral endoscopic myotomy. Postoperatively, his dysphagia, weight loss, and intractable hiccups resolved.
ACG Case Rep J 2019 Apr
PMID:Poetic Justice: A Case of Resolved Intractable Hiccups Following POEM for Achalasia. 3161 24

Achalasia is a rare condition that most often presents with progressive dysphagia to solids and liquids. We report a case of achalasia presenting with acute respiratory failure and hemodynamic instability requiring both ventilator and vasopressor support because of extrinsic compression of the airway and left atrium by a dilated and fluid-filled esophagus. This is the first case reported of achalasia, causing both left atrial compression and airway compression.
ACG Case Rep J 2020 Jan
PMID:Achalasia Revealed by Respiratory Failure and Hemodynamic Instability. 3230 92

Achalasia is an esophageal motility disorder characterized by a lack of peristalsis and an increased lower esophageal sphincter pressure that does not relax with swallowing. High-resolution manometry (HRM), a valuable diagnostic tool for esophageal disorders, often comes with software for automated study interpretation. Although helpful, there are certain caveats in the diagnostic criteria for achalasia which the software may miss. We highlight 2 patients in whom software analysis of HRM studies resulted in misdiagnosis of achalasia as manometrically detected nonachalasia esophagogastric junction outflow obstruction and emphasize the importance of manual interpretation of HRM data by clinicians.
ACG Case Rep J 2020 Mar
PMID:The Role of Automatically Generated Chicago Classification in Delayed Achalasia Diagnosis. 3233 11

Pseudoachalasia, clinically indistinct from achalasia in symptoms and high-resolution manometry findings, differs by a secondary etiology with more than half of the occurrences arising from malignancy. Rarely pseudoachalasia presents after surgeries of the esophagus and gastroesophageal junction. This case offers an additional example of pseudoachalasia after Nissen fundoplication; however, it is unique to the literature by documenting complete manometric progression from normal to pseudoachalasia in a single patient. This case serves to highlight the importance of thorough workups in patients with achalasia symptoms and broadens understanding of this disease process by offering manometric findings in an evolutionary phase.
ACG Case Rep J 2020 Feb
PMID:Pseudoachalasia Following Nissen Fundoplication. 3244 May 24


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