Disfagia Esofágica Motora por Acalasia

Abstract

This case is a patient of 45 years with a history of appendectomy surgery 30 years ago whose table starts with dysphagia to solid foods from 4 years of evolution the same as is exacerbated by intake of coffee, yields on standing. The clinical picture heartburn of moderate intensity, acidity and weight loss adds, comes to optional city of Guayaquil who prescribe nifedipine 20 mg with what frame partially improves, 6 months picture makes progress to dysphagia to liquids and vomiting postprandial so CSN who comes to one where it is valued and derived Ambato Provincial Teaching Hospital where he is assessed by outpatient Gastroenterology. Physical examination pale presence of halitosis patient, level painful to deep palpation epigastrium. Additional tests are sent Endoscopy being found in the presence of nonprogressive peristaltic waves that form rings protruding into the light suggestive eosinophilic esophagitis, plus slight deformity in the distal esophagus difficult to pass the equipment. A level of antral stomach ulcer seen in healing process corresponding to a Forrest III.

It sends Series Gastroduodenal meeting esophageal dilation throughout the thoracic segment of the esophagus reaching a maximum diameter of 6.5cm leading to radiological sign of beak, plus certain irregularities at the level above which suggests investigate cardinal esophagitis. Two months ago Esophageal manometry examination is performed High Resolution being found lower esophageal sphincter pressure at the upper limit of normal but with no relaxation swallows concluding the study with a diagnosis of achalasia Type I classification of Chicago.

Currently patient post-surgery recovery definitive Heller myotomy with fundoplication more Door type.