Previously treated oesophageal achalasia re-presenting with stridor

Abstract

Achalasia is a motility disorder of the oesophagus that typically presents with dysphagia, regurgitation and chest pain. A rare presenting symptom is stridor. A case of previously treated achalasia re-presenting with stridor is described and associated imaging presented.

Acute upper airway obstruction due to oesophageal achalasia

“…Oesphageal achalasia is an idiopathic motility disorder of the oesophagus, characterised by impaired relaxation of the lower oesophageal sphincter and oesophageal aperistalsis, with resultant dilatation of the oesophagus [1][2][3].…”

“…Thoracic paravertebral block has usually been performed using a loss of resistance technique [1,2] with the transverse process is an important landmark. However, since the transverse process is neither visible nor palpable, its location is unknown until the block needle encounters the bone.…”

“…systems to objectively evaluate intubating conditions [1]. A third investigator may well have lent more weight but additional utilisation of a standardised scoring system would add further objectivity especially given the difficulties in blinding investigators and patients to specific techniques.…”

“…There was nothing of note in her medical history. On examination, she weighed 42 kg: above the 97th centile for her age [1]. Her arm was supported by an above elbow plaster of paris cast and held in a sling.…”

“…Oesphageal achalasia is an idiopathic motility disorder of the oesophagus, characterised by impaired relaxation of the lower oesophageal sphincter and oesophageal aperistalsis, with resultant dilatation of the oesophagus [1–3]. Respiratory complications can occur secondary to food regurgitation, with aspiration and respiratory tract infection as a result.…”