title: Rare case of upper gastrointestinal bleeding in achalasia.
abstract: Achalasia is a prototypic esophageal motility disorder with complications including aspiration-pneumonia, esophagitis, esophageal-tracheal fistula, spontaneous rupture of the esophagus, and squamous cell carcinoma. However, achalasia is rarely associated with esophageal stones and ulcer formation that lead to upper gastrointestinal bleeding. Here, we report the case of a 61-year-old woman who was admitted to our department after vomiting blood for six hours. Physical examination revealed that the patient had severe anemia and mild palpitation in the upper abdomen. CT revealed lower esophageal dilatation and esophageal wall thickening, and an emergency upper endoscopy showed that the esophagus was substantially expanded by a dark round stone, with multiple ulcers on the esophageal wall and a slit in the cardiac mucosa with a large clot attached. The patient's history included ingestion of 1 kg hawthorn three days prior. The acute upper gastrointestinal bleeding was caused by Mallory-Weiss syndrome associated with achalasia and an esophageal stone. For patients with achalasia, preventing excessive ingestion of tannins is crucial to avoid complications such as bleeding and rupture.
authors: Wei-Wei Zhang, Xiang-Jun Xie, Chang-Xin Geng, Shu-Hui Zhan, Department of Gastroenterology, Municipal Hospital of Qingdao, Qingdao 266000, Shandong Province, China.
authors: Wei-Wei
authors: WW
authors: Zhang
authors: Wei-Wei Zhang, Xiang-Jun Xie, Chang-Xin Geng, Shu-Hui Zhan, Department of Gastroenterology, Municipal Hospital of Qingdao, Qingdao 266000, Shandong Province, China.
authors: Xiang-Jun
authors: XJ
authors: Xie
authors: Wei-Wei Zhang, Xiang-Jun Xie, Chang-Xin Geng, Shu-Hui Zhan, Department of Gastroenterology, Municipal Hospital of Qingdao, Qingdao 266000, Shandong Province, China.
authors: Chang-Xin
authors: CX
authors: Geng
authors: Wei-Wei Zhang, Xiang-Jun Xie, Chang-Xin Geng, Shu-Hui Zhan, Department of Gastroenterology, Municipal Hospital of Qingdao, Qingdao 266000, Shandong Province, China.
authors: Shu-Hui
authors: SH
authors: Zhan
keywords: Achalasia; Esophageal stone; Mallory-Weiss syndrome; Upper gastrointestinal bleeding