Palliation with oesophageal metal stent of pseudoachalasia from gastric carcinoma at the cardia: a case report.
We present an 82-year-old woman with a 3-month history of progressive dysphagia and a normal initial upper gastrointestinal endoscopy. The diagnosis of pseudoachalasia was suspected by oesophageal manometric and barium swallow studies, and confirmed by biopsies revealing an intestinal type carcinoma of the stomach at a repeated endoscopy. In view of the history of heart disease, diabetes, and old age, this patient was treated by a partially covered Ultraflex self-expanding metal stent (Boston Scientific, Natick, MA, USA) placed into the oesophageal body with no direct complications and obtaining the relief from dysphagia. During the 11-month follow-up she was treated for an iron deficiency anaemia due to reflux oesophagitis with ulcerations in the oesophageal body and died from myocardial infarction. According to the localization of the cancer, the old age, and the presence of comorbidities, we should recommend the insertion of a partially covered self-expanding metal stent as a reasonable palliative treatment in selected subjects with pseudoachalasia.
Campo
Salvatore Maria Antonio
SM
Gastroenterology Unit, Nuovo Regina Margherita Hospital, Via Morosini 30, 00153 Rome, Italy.
Lorenzetti
Roberto
R
de Matthaeis
Marina
M
Hassan
Cesare
C
Zullo
Angelo
A
Cerro
Paola
P
Morini
Sergio
S