title: Oesophageal achalasia misdiagnosed as uncontrolled asthma.
abstract: Achalasia is characterized by incomplete lower oesophageal sphincter relaxation and aperistalsis of the oesophagus. It may present with dyspnea symptom. An 18-years-old male patient applied to a clinic with the complaints of cough, dyspnea, wheezing and diagnosed as asthma. Although his asthma treatment was increased in time while he did not recover, he was reffered to our hospital with the diagnosis of uncontrolled asthma. On chest X-ray there was a mild upper mediastinal enlargement and chest computed tomography revealed an over-dilated oesophagus constricting the trachea. The patient was referred to chest surgery clinic with a suspected diagnosis of achalasia. Barium-oesophagogram and endoscopic evaluation of the oesophagus confirmed the diagnosis of achalasia. The patient underwent Heller myotomy and oesophagogastrostomy. He was recovered in one week after the surgery without any complaint of dyspnea. Spirometry tests and chest X-ray resulted normal in one year. With this case of achalasia who used asthma treatment unnecessarily,we wanted to emphasize the importance of differential diagnosis of difficult asthma.
authors.affiliation: Division of Immunology and Allergy, Department of Chest Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey. mdomuraydin@gmail.com
authors.forename: Ömür
authors.initials: Ö
authors.lastname: Aydın
authors.forename: Cabir
authors.initials: C
authors.lastname: Yüksel
authors.forename: Timur
authors.initials: T
authors.lastname: Tuncalı
authors.forename: Murat
authors.initials: M
authors.lastname: Ozkan
authors.forename: Akın
authors.initials: A
authors.lastname: Kaya
authors.forename: Ilker
authors.initials: I
authors.lastname: Ökten
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Mısırlıgil
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000175:diagnosis*; D003371:Cough / Q000175:diagnosis; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004106:Dilatation; D004417:Dyspnea / Q000175:diagnosis; D004931:Esophageal Achalasia / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male; D012135:Respiratory Sounds / Q000175:diagnosis