Oesophageal achalasia misdiagnosed as uncontrolled asthma

Print doi:10.5578/tt.5778 [ Fulltext ] [ PDF ] Ömür AYDIN1, Cabir YÜKSEL2, Timur TUNCALI3, Murat ÖZKAN2, Akın KAYA4, İlker ÖKTEN2,  Zeynep MISIRLIGİL1 1 Division of Immunology and Allergy, Department of Chest Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey, 2 Department of Chest Surgery, Faculty of Medicine, Ankara University, Ankara, Turkey, 3 Department of Medical Genetic, Faculty of Medicine, Ankara University, Ankara, Turkey, 4 Department of Chest Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey. SUMMARY 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. Key Words: Difficult asthma, uncontrolled asthma, differential diagnosis, oesophageal achalasia Tuberk Toraks 2013; 61(2): 147-151 • doi: doino: 10.5578/tt.5778 Geliş Tarihi/Received: 04/03/2013 - Kabul Ediliş Tarihi/Accepted: 29/04/2013 Address for Correspondence: Dr. Ömür AYDIN, Ankara Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, İmmünoloji ve Allerji Bilim Dalı, 06100 Dikimevi, ANKARA - TURKEY e-mail: mdomuraydin@gmail.com [ Fulltext ] [ PDF ] Print