Pseudoachalasia Secondary to Thoracic Aortic Aneurysm

Beqari, Jorind; Lembo, Anthony; Critchlow, Jon; Hamden, Allen; Kent, Michael S.

doi:10.1016/j.athoracsur.2016.11.084

Cited by 6 publications

(5 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It appears that the main cause of pseudoachalasia is an adenocarcinoma at the GEJ; however, similar effects have been also reported with multiple other cancers such as lung, pancreatic, breast, and cervical cancers, pleural mesothelioma, and multiple myeloma [14][15][16][17][18][19][20][21]. Nonmalignant causes of pseudoachalasia include, but are not limited to, amyloidosis, sarcoidosis, thoracic aortic aneurysm, systemic mastocytosis, Chagas disease, neurofibromatosis, histiocytosis-x, and Fabry disease with the accumulation of lysosomal Gb3 [6,[22][23][24][25][26][27][28][29]. Anti-reflux surgery can also lead to pseudoachalasia due to misdiagnosed idiopathic achalasia with dysphagia symptoms postoperatively, underlying gastroesophageal reflux leading to achalasia, and an excessively tight fundic wrap or scar tissue development postoperatively.…”

Section: Discussionmentioning

confidence: 80%

Delayed Presentation of Malignancy-Associated Pseudoachalasia of the Gastric Cardia

Miranda,

Azad,

Moyer

et al. 2024

Cureus

View full text Add to dashboard Cite

Pseudoachalasia is a condition in which symptoms, manometry, and imaging findings highly resemble primary achalasia but has a secondary etiology. The majority of patients with pseudoachalasia have the condition as the result of a malignancy, most often at the gastroesophageal junction. There may be issues with timely identification of this malignancy as symptoms are often obscure with diagnostic testing yielding nonspecific results. We describe a case of a 65-year-old diabetic female smoker with a four-month history of intractable vomiting, abdominal pain, and weight loss who was belatedly found to have an adenocarcinoma at the gastric cardia necessitating a total gastrectomy and chemotherapy administration. The case educates clinicians on the clinical alarm symptoms related to malignant pseudoachalasia and stresses the paramount importance of performing a timely esophagogastroduodenoscopy in all cases of achalasia, even with seemingly normal imaging, to rule out pseudoachalasia related to malignancy.

show abstract

Section: Discussionmentioning

confidence: 80%

Delayed Presentation of Malignancy-Associated Pseudoachalasia of the Gastric Cardia

Miranda,

Azad,

Moyer

et al. 2024

Cureus

View full text Add to dashboard Cite

show abstract

“…As in dysphagia lusoria, an underlying esophageal motility disorder may be present in some of these patients, particularly in those without evidence of aneurysm [ 28 , 29 ]. It has also been speculated that long-lasting esophageal compression may evolve into esophageal pseudoachalasia, a rare condition accounting for less than 5% of patients with achalasia-like syndrome [ 30 , 72 , 78 ]. Reported findings at esophageal manometry are low-amplitude propagated peristaltic waves in the proximal esophagus and a localized high-pressure zone at the site of vascular compression.…”

Section: Discussionmentioning

confidence: 99%

Dysphagia aortica

et al. 2021

View full text Add to dashboard Cite

Summary Background Dysphagia aortica is an umbrella term to describe swallowing obstruction from external aortic compression secondary to a dilated, tortuous, or aneurysmal aorta. We performed a systematic literature review to clarify clinical features and outcomes of patients with dysphagia aortica. Materials and methods We searched PubMed, EMBASE, Web of Science, and the Cochrane Library. The terms “aortic dysphagia,” “dysphagia aortica,” “dysphagia AND aortic aneurysm” were matched. We also queried the prospectively updated database of our esophageal center to identify patients with aortic dysphagia referred for diagnosis and treatment over the past two decades. Results A total of 57 studies including 69 patients diagnosed with dysphagia aortica were identified, and one patient from our center was added to the database. The mean age was 72 years (range 22–98), and the male to female ratio 1.1:1. Of these 70 patients, the majority (n = 63, 90%) had an aortic aneurysm, pseudoaneurysm, or dissection. Overall, 37 (53%) patients received an operative treatment (81.1% a vascular procedure, 13.5% a digestive tract procedure, 5.4% both procedures). Thoracic endovascular aortic repair (TEVAR) accounted for 60% of all vascular procedures. The postoperative mortality rate was 21.2% (n = 7/33). The mortality rate among patients treated conservatively was 55% (n = 11/20). Twenty-six (45.6%) studies were deemed at a high risk of bias. Conclusion Dysphagia aortica is a rare clinical entity with high morbidity and mortality rates and no standardized management. Early recognition of dysphagia and a high suspicion of aortoesophageal fistula may be lifesaving in this patient population.

show abstract

“…To our knowledge, only one previous case report described the pitfall of missing pseudoachalasia secondary to vascular compression when the initial examinations indicate primary achalasia [8]. Dysphagia caused by an aneurysm of the aorta is called dysphagia aortica.…”

Section: Discussionmentioning

confidence: 99%

Case report: an aortic aneurysm as cause of pseudoachalasia

et al. 2020

View full text Add to dashboard Cite

Background: Pseudoachalasia is a rare disorder which has clinical, radiographic, and manometric findings that are often indistinguishable from primary achalasia. It is usually associated with malignancy. Few reports describe vascular compression as a cause of pseudoachalasia. Case presentation: Here we present a case of a 84-year-old woman with anorexia, dysphagia and unintentional weight loss initially diagnosed as achalasia. Upon further investigation a rare cause of pseudoachalasia due to vascular compression of the esophagus was found. It could have been overlooked due to the fact that the initial work-out with a barium swallow, manometry and endoscopy was suggestive for primary achalasia. Conclusion: Particularly in older patients with a manometric diagnosis of achalasia, additional investigation to rule out pseudoachalasia is warranted. Although malignant involvement of the esophagus is the most common cause of pseudoachalasia, benign origins have also been described.

show abstract

Pseudoachalasia Secondary to Thoracic Aortic Aneurysm

Cited by 6 publications

References 8 publications

Delayed Presentation of Malignancy-Associated Pseudoachalasia of the Gastric Cardia

Delayed Presentation of Malignancy-Associated Pseudoachalasia of the Gastric Cardia

Dysphagia aortica

Case report: an aortic aneurysm as cause of pseudoachalasia

Contact Info

Product

Resources

About