A Patient with Achalasia with Complication Mega-Esophagus: A Case Report

Abstract

A 51-year-old male presented with a history of progressive dysphagia and regurgitation for 6 years. The patient experienced significant weight loss and worsening dysphagia over the past 2 years. A chest X-ray led to a conclusion of esophageal achalasia meanwhile a CT Scan revealed dilation of the cervical, thoracic, and abdominal parts of the esophagus. The patient underwent an initial esophagogastroduodenoscopy (EGD), which revealed a dilated esophageal lumen, a sigmoid-shaped formation in the distal esophagus, and hypertension at the esophago-gastric junction (EGJ). The patient underwent minimal invasive dilation of the EGJ using an endoscopic pneumatic balloon in two sessions one month apart. After a 1-month evaluation post the final EGD, dysphagia symptoms worsened and dilation of an aperistaltic segment from the proximal to distal esophageal lumen was observed. Subsequently, the patient is planned to undergo double set up Heller myotomy surgery and, if necessary, esophageal resection.