title: Achalasia presenting as acute stridor.
abstract: We report a case of achalasia presenting as acute stridor and respiratory distress in an 87-year-old woman. A mega-oesophagus was decompressed by aspiration through a naso-oesophageal tube, stiffened with paediatric endoscopic biopsy forceps before placement. Subsequent barium swallow showed mega-oesophagus secondary to achalasia causing tracheal compression at the level of the thoracic inlet. There have been 28 previous case reports of mega-oesophagus due to achalasia causing tracheal obstruction and the literature is reviewed. Recognition and urgent treatment of this very rare complication of achalasia by naso-oesophageal decompression may avoid fatality.
authors.affiliation: Gastroenterology Unit, Derriford Hospital, Plymouth, UK.
authors.forename: S P
authors.initials: SP
authors.lastname: Dunlop
authors.forename: S P
authors.initials: SP
authors.lastname: Travis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000000981:diagnostic imaging / Q000209:etiology*; D017609:Barium Compounds; D004931:Esophageal Achalasia / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D011859:Radiography; D012135:Respiratory Sounds / Q000175:diagnosis*
chemical_list: D017609:Barium Compounds