title: Achalasia with megaesophagus and tracheal compression in a young patient: A case report.
abstract: BACKGROUND
  Achalasia is one of the most common causes of dysphagia. Typical symptoms include difficulties in controlling the swallowing process, regurgitation, weight loss, and chest pain. A megaesophagus rarely causes tracheal compression with consecutive acute dyspnea or similar respiratory symptoms.
  
  
  METHODS
  A 23-year-old male patient presented with difficulties in swallowing, a consecutive massive weight loss over the past three years, and minor respiratory ailments. Further diagnostics revealed a megaesophagus caused by achalasia leading to a severe compression of the trachea. A laparoscopic Heller myotomy with anterior semi-fundoplication 180° according to Dor was performed.
  
  
  CONCLUSIONS
  Acute dyspnea and similar respiratory symptoms are rarely observed in patients with achalasia, especially in young patients. Early diagnosis and timely, proper treatment are the hallmarks of restoring esophageal and tracheobronchial function and of successful prevention of severe long-lasting complications of the disease. When not treated properly, the disease may have progressed rapidly, leading to distinct respiratory symptoms such as stridor and acute dyspnea
  
  
  CONCLUSIONS
  This report emphasizes that physicians should be alert and consider airway obstruction and signs of dyspnea as severe and threatening symptoms in extensive cases of achalasia with megaesophagus. Early surgical treatment provides a therapeutic option to obviate the occurrence of acute respiratory distress and consecutive complications. In particular, difficulties in intubation prior to surgery must be considered.
authors.affiliation: Department of General-, Visceral- and Transplant Surgery, University Medical Centre, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany. Electronic address: moritz.kaths@gmail.com.
authors.forename: J Moritz
authors.initials: JM
authors.lastname: Kaths
authors.affiliation: Department of General-, Visceral- and Transplant Surgery, University Medical Centre, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany.
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Foltys
authors.affiliation: Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Scheuermann
authors.affiliation: Deutsche Stiftung Organtransplantation, Region Mitte, Frankfurt, Germany.
authors.forename: Mari
authors.initials: M
authors.lastname: Strempel
authors.affiliation: Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Niebisch
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Medical Centre, Johannes Gutenberg-University Mainz, Germany.
authors.forename: Maren
authors.initials: M
authors.lastname: Ebert
authors.affiliation: Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Germany.
authors.forename: Boris
authors.initials: B
authors.lastname: Jansen-Winkeln
authors.affiliation: Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Germany.
authors.forename: Ines
authors.initials: I
authors.lastname: Gockel
authors.affiliation: Department of General-, Visceral- and Transplant Surgery, University Medical Centre, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany.
authors.forename: Hauke
authors.initials: H
authors.lastname: Lang
keywords: Achalasia; Megaesophagus; Tracheal compression