Acalasia. Nuevos conceptos

A Rare Case of a Life-Threatening Massive Upper Gastrointestinal Bleed and Airway Obstruction in a Patient With a Megaesophagus Secondary to Longstanding Achalasia

“…However, a normal EGD cannot rule out achalasia, as 40% of achalasia patients will have a normal endoscopy [15]. The gold standard for diagnosing achalasia is esophageal manometry, which demonstrates esophageal aperistalsis and increased LES pressure [1,[6][7]. Another commonly used diagnostic test is a barium esophagram, which shows a pathognomonic "birds beak" appearance of the distal esophagus with proximal esophageal dilation [7,10].…”

“…Achalasia is an idiopathic primary motor disorder characterized by esophageal aperistalsis and incomplete relaxation of the lower esophageal sphincter (LES) [1][2][3]. The underlying pathophysiology is attributed to a functional loss of the myenteric plexus of Auerbach, resulting in an impairment of the inhibitory postganglionic neurons in the distal esophagus and LES [4][5][6].…”

“…The underlying pathophysiology is attributed to a functional loss of the myenteric plexus of Auerbach, resulting in an impairment of the inhibitory postganglionic neurons in the distal esophagus and LES [4][5][6]. The inability of the LES to relax upon swallowing causes progressive dysphagia for both solids and liquids with accompanied retrosternal chest pain from the regurgitation of food debris and fluids, along with halitosis [1,4,[7][8].…”