Pseudoachalasia secondary to bariatric surgery.
Secondary achalasia may result from diseases that either infiltrate or compress the lower esophageal sphincter to create an increased high-pressure zone and subsequent esophageal body changes. With bariatric surgery, a potential high-pressure zone is created by a sleeve, band, or bypass just distal to the esophagus. We report four patients who years after a bariatric procedure developed dysphagia followed by esophageal body radiographic and/or manometric features of achalasia. In addition, each of these patients responded symptomatically to endoscopic or surgical therapy either which lowered this high-pressure zone. Furthermore, review of prior cases in the literature suggests this has occurred before. Physicians should be aware of this association but further study is needed on its true prevalence.
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
K
K
Ravi
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
S
S
Sweetser
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
D A
DA
Katzka
D000368:Aged; D050110:Bariatric Surgery / Q000009:adverse effects*; D001466:Barium Sulfate; D003287:Contrast Media; D003680:Deglutition Disorders / Q000209:etiology / Q000503:physiopathology*; D004931:Esophageal Achalasia / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D049630:Esophageal Sphincter, Lower / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008365:Manometry; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011312:Pressure; D011859:Radiography
D003287:Contrast Media; D001466:Barium Sulfate
achalasia; bariatric surgery; dysphagia