title: Esophageal achalasia and coexistent upper esophageal sphincter relaxation disorder presenting with airway obstruction.
abstract: Acute airway obstruction associated with esophageal achalasia is an uncommon but life-threatening complication. The pathophysiology of this phenomenon has not been fully defined. A fully documented case of coexistent esophageal achalasia and upper esophageal sphincter relaxation abnormality presenting with airway obstruction is reported. The patient was initially treated with Heller's myotomy but had a recurrence of respiratory distress. She was successfully treated by cricopharyngeal myotomy. The causes of gas entrapment and respiratory distress are likely to be due to failure of both swallow- and distention-induced upper esophageal sphincter relaxation. Cricopharyngeal myotomy is an effective treatment for this complication, probably by facilitating esophagopharyngeal gas venting.
authors.affiliation: Department of Gastroenterology, St. George Hospital, University of New South Wales, Sydney, Australia.
authors.forename: G N
authors.initials: GN
authors.lastname: Ali
authors.forename: D R
authors.initials: DR
authors.lastname: Hunt
authors.forename: J O
authors.initials: JO
authors.lastname: Jorgensen
authors.forename: D J
authors.initials: DJ
authors.lastname: deCarle
authors.forename: I J
authors.initials: IJ
authors.lastname: Cook
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000209:etiology*; D004931:Esophageal Achalasia / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D015154:Esophageal Motility Disorders / Q000150:complications*; D004943:Esophagogastric Junction / Q000503:physiopathology*; D005260:Female; D006801:Humans; D009126:Muscle Relaxation