pseudoachalasia
(Redirected from PSEUDO ACHALASIA)
Etiology
- tumor
- esp adenocarcinoma of gastroesophageal junction
- gastric cancer (involving cardia)
- esophageal cancer (distal esophagus)
- pancreatic cancer
- breast cancer
- direct tumor infiltration of paraneoplastic syndrome[3]
- lung cancer
- heptocellular carcinoma
- esp adenocarcinoma of gastroesophageal junction
- amyloidosis
- sarcoidosis
- surgery: Nissan fundoplication, bariatric surgery
Epidemiology
- 10% of patients > 60 years of age presenting with symptoms suggestive of achalasia
Pathology
- invasion of the lower esophageal sphincter
- encircling or compressing the distal esophagus
- infiltrating the esophageal Auerbach plexus
Clinical manifestations
- dysphagia to both solids & liquids
- chest pain, regurgitation[3]
- short duration of symptoms (months)
- weight loss
- symptoms mimic achalasia
Diagnostic procedures
- endoscopy with biopsy
- mucosal ulcerations or nodularity
- grossly normal esophagus, stomach, & duodenum.
- may be normal because of submucosal involvement
- elevated lower esophageal sphincter pressure & no normal peristalsis
- spastic contractions with swallowing
- may be difficult to pass the endoscope into the stomach
- endoscopic ultrasound[2]
Radiology
- CT of abdomen & thorax, looking closely at the gastroesophageal junction
Differential diagnosis
More general terms
Additional terms
References
- ↑ UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
- ↑ 2.0 2.1 Medical Knowledge Self Assessment Program (MKSAP) 15, 18. American College of Physicians, Philadelphia 2009, 2018
Medical Knowledge Self Assessment Program (MKSAP) 20 American College of Physicians, Philadelphia 2025 - ↑ 3.0 3.1 3.2 Ponds FA, van Raath MI, Mohamed SMM et al Diagnostic features of malignancy-associated pseudoachalasia. Aliment Pharmacol Ther. 2017 Jun;45(11):1449-1458. PMID: https://pubmed.ncbi.nlm.nih.gov/28382674