Acute Airway Obstruction Secondary to Achalasia Mega-oesophagus

Abstract

Acute airway obstruction is a very rare presentation of achalasia. We report the case of a 78-year-old woman with previously undiagnosed achalasia who presented with acute respiratory distress and stridor due to tracheal compression by mega-oesophagus. Anaesthetists and physicians caring for patients with achalasia must be aware of the need for emergency oesophageal decompression in this rare and life-threatening condition.

Achalasia with megaesophagus and tracheal compression in a young patient: A case report

“…Only very few cases of tracheal compression due to extensive dilation of the esophagus in achalasia are reported in the literature and therefore represent a rare feature of the disease [11–14] . The radiologic signs and clinical symptoms in these patients may vary and are often unspecific – independently of the stage of achalasia – and thus might be present at even rather early stages of the disease.…”

Idiopathic Oesophageal Dysmotility Disorder: Stridor Secondary to Megaesophagus

“…In cases of achalasia as the primary cause of an obstructing megaesophagus, these patients usually present subacutely with slowly increasing airway compromise. Decompression of the oesophagus via passage of a wide-bore nasogastric tube has been reported to be a simple and highly successful method of treatment, with the patients improving within a matter of minutes [1]. …”

Improvement of Respiratory Symptoms Following Heller Myotomy for Achalasia

“…These include case reports of atypical infections, hoarseness resulting from recurrent laryngeal nerve compression, and more serious and lifethreatening complications such as stridor and tracheal obstruction from airway compression. 3,[21][22][23][24][25][26][27][28] To our knowledge, no prior studies have examined what effect surgical treatment with Heller myotomy has on respiratory disorders associated with achalasia. In this study, we set up to systematically examine the effect of this operation on these symptoms.…”