Pseudoachalasia: a systematic review of the literature

Schizas, Dimitrios; Theochari, Nikoletta A; Katsaros, Ioannis; Mylonas, Konstantinos S.; Triantafyllou, Tania; Michalinos, Adamantios; Kamberoglou, Dimitrios; Tsekrekos, Andrianos; Rouvelas, Ioannis

doi:10.1007/s10388-020-00720-1

Cited by 26 publications

(33 citation statements)

References 46 publications

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“…In up to 70% of these cases, an infiltrating adenocarcinoma of the gastro-oesophageal junction arising in the cardia or on a Barrett’s oesophagus is implicated [3]. Other less frequent malignant causes with a similar effect are mediastinal and peritoneal metastases and other neoplasms including those of lung, breast, pancreas, and kidney [3, 4]. Laparoscopic adjusting gastric banding is the most common non-malignant cause (6%) of pseudoachalasia [3].…”

Section: Discussionmentioning

confidence: 99%

“…Other less frequent malignant causes with a similar effect are mediastinal and peritoneal metastases and other neoplasms including those of lung, breast, pancreas, and kidney [3, 4]. Laparoscopic adjusting gastric banding is the most common non-malignant cause (6%) of pseudoachalasia [3]. Diverse rare cases of pseudoachalasia secondary to sarcoidosis, amyloidosis, infectious diseases (e.g., Chagas’ disease) as well as cases following vagotomy, Nissen’s fundoplication, descending aorta aneurysm, histiocytosis, mediastinal fibrosis, and post-sleeve gastrectomy have been reported [3].…”

Section: Discussionmentioning

confidence: 99%

“…Alternatively, malignant invasion of the myenteric plexus can result in dysmotility. Pseudoachalasia also occurs as a paraneoplastic syndrome, mostly associated to small cell lung cancers, with autoimmune damage to the myenteric plexus [3].…”

Section: Discussionmentioning

confidence: 99%

“…Pseudoachalasia, also known as secondary achalasia, is a rare clinical condition mimicking idiopathic achalasia. It accounts for 2 to 5% of patients with an achalasia-like syndrome [3, 4]. Whereas primary achalasia is generated by primary degeneration of the oesophageal ganglion cells, and especially the inhibiting nitrergic neurons, pseudoachalasia has most commonly been described in relation to underlying malignancy [1, 3].…”

Section: Introductionmentioning

confidence: 99%

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A Bitter Pill to Swallow: Pseudoachalasia Secondary to Oesophageal Deviation Resulting from Mediastinal Shift and Left Atrial Enlargement after Left Lower Lobectomy

Surmont

Aerts

Kunda

et al. 2020

Case Rep Gastroenterol

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Pseudoachalasia, also known as secondary achalasia, is a rare clinical condition mimicking idiopathic achalasia but unrelated to primary loss of nitrergic innervation. It has mostly been attributed to malignancy infiltrating the oesophageal wall, but several other benign underlying pathologies have been reported. Because of similar manometric appearance, high-resolution manometry (HRM) of the oesophagus alone cannot distinguish between idiopathic achalasia and pseudoachalasia. Misdiagnosis can result in ineffective treatment by dilatation or even more invasive therapy. This is the first case-report of pseudoachalasia secondary to oesophageal deviation resulting from mediastinal shift and left atrial enlargement following prior left lower lobectomy. HRM, the gold standard for the diagnosis of achalasia, confirmed the incomplete relaxation of the lower oesophageal sphincter (LES) in absence of normal oesophageal peristalsis. However, additional workup with CAT scan and cardiac ultrasound identified an anatomical shift by the extrinsic mass effect resulting from the atrial enlargement, but without contrast retention at the LES.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Bitter Pill to Swallow: Pseudoachalasia Secondary to Oesophageal Deviation Resulting from Mediastinal Shift and Left Atrial Enlargement after Left Lower Lobectomy

Surmont

Aerts

Kunda

et al. 2020

Case Rep Gastroenterol

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“…После углубленного обследования, с учетом данных манометрии, у пациента была выявлена инфильтративно растущая аденокарцинома пищевода. Можно предположить, если бы уровень стриктуры, обусловленный опухолевым ростом располагался на уровне кардии, манометрическая картина полностью соответствовала бы картине ахалазии II манометрического типа и это был бы ещё один случай псевдоахалазии, многократно описанной ранее [19]. Однако, в нашем случае у нас была редкая возможность увидеть, что скрывается за тотальной прессуризацией.…”

Section: Introductionunclassified

Type II achalasia. What can be hidden behind panesophageal pressurization?

Смирнов¹,

Кирильцева²,

Любченко³

2020

jour

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The aim was to investigate features of manometric pattern of type II achalasia.Materials and methods: High-resolution esophgeal manometry (HRM) was performed in 250 patients with achalasia. In 154 cases patients underwent peroral esophageal myotomy (POEM).Results: We found that poor results after POEM showed patients with high preoperative esophageal pressurization (>80 mm Hg). The poorest result after POEM we observed in patient with short additional increase of panesophageal pressure (up to 95 mm Hg) withing the contour of panesophageal pressurization.

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Global trends in incidence and prevalence of achalasia, 1925–2021: A systematic review and meta‐analysis

Lee,

Hong,

Yoo

et al. 2024

UEG Journal

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BackgroundAchalasia poses a significant socioeconomic burden, yet global trends remain undocumented. This study aims to describe the worldwide trends in the incidence and prevalence of achalasia from 1925 to 2021 and explore their correlation with various factors through a comprehensive systematic review.MethodsWe searched the PubMed/MEDLINE, Embase, and Cochrane databases from inception to 30 June 2023, to identify studies reporting the incidence or prevalence of achalasia in the general population. This study utilized pooled estimates with 95% confidence intervals (CI) to estimate the incidence and prevalence of achalasia, and conducted various subgroup analyses.ResultsA total of 26 eligible studies covering approximately 269 million participants and 20,873 patients from 14 countries across five continents were included. Global pooled incidence and prevalence of achalasia were estimated to be 0.78 cases per 100,000 person‐years (95% CI, 0.64–0.93; number of studies, 26; sample population, 269,315,171) and 10.82 cases per 100,000 person‐years (95% CI, 8.15–13.48; number of studies, 14; sample population, 192,176,076), respectively. The incidence of achalasia was higher in Oceania (than Asia and Africa) and in adults (than children) after the introduction of the Chicago classification. Prevalence followed a similar pattern. The pooled incidence of achalasia showed an overall upward trend from 1925 to 2021 (1925–1999; 0.40 [0.32–0.49] vs. 2018–2021; 1.64 [1.33–1.95] cases per 100,000 person‐years).ConclusionsThe incidence and prevalence of achalasia have notably increased, particularly with advancements in diagnosis, and show significant variation worldwide, despite the large heterogeneity within the sample population. Further studies are necessary to accurately assess the global incidence and prevalence of achalasia.

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Pseudoachalasia: a systematic review of the literature

Cited by 26 publications

References 46 publications

A Bitter Pill to Swallow: Pseudoachalasia Secondary to Oesophageal Deviation Resulting from Mediastinal Shift and Left Atrial Enlargement after Left Lower Lobectomy

A Bitter Pill to Swallow: Pseudoachalasia Secondary to Oesophageal Deviation Resulting from Mediastinal Shift and Left Atrial Enlargement after Left Lower Lobectomy

Type II achalasia. What can be hidden behind panesophageal pressurization?

Global trends in incidence and prevalence of achalasia, 1925–2021: A systematic review and meta‐analysis

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