Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Filter by Categories
Book Review
Book Reviews
Classics In Indian Medicine
Clinical Case Report
Clinical Case Reports
Clinical Research Methods
Clinico-pathological Conference
Eminent Indians in Medicine
Everyday Practice
Film Review
History of Medicine
Images In Medicine
Indian Medical Institutions
Letter from Bristol
Letter from Chennai
Letter From Ganiyari
Letter from Glasgow
Letter from London
Letter From Mumbai
Letter From Nepal
Medical Education
Medical Ethics
Medicine and Society
News From Here And There
Notice of Retraction
Original Article
Original Articles
Review Article
Selected Summaries
Selected Summary
Short Report
Short Reports
Speaking for Myself
Speaking for Ourselve
Speaking for Ourselves
View/Download PDF

Translate this page into:

Images In Medicine
doi: 10.4103/0970-258X.323455
PMID: 34397011

Achalasia cardia presenting with tracheal compression

Saurabh Mittal, Karan Madan, Pawan Tiwari, Anant Mohan, Vijay Hadda
 Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India

Corresponding Author:
Saurabh Mittal
Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi
Published: 10-Aug-2021
How to cite this article:
Mittal S, Madan K, Tiwari P, Mohan A, Hadda V. Achalasia cardia presenting with tracheal compression. Natl Med J India 2021;34:55
Copyright: (C)2021 The National Medical Journal of India

A 37-year-old man presented with difficulty in swallowing for the past 3 years. He initially had dysphagia to liquids only; however, for the past year, he had difficulty in taking solids as well. He started having a cough associated with exertional dyspnoea for 3 months and had lost 8 kg weight. He had been taking over-the-counter antacids and oral pantoprazole with symptomatic relief. On examination, he had pallor, and the rest of the physical examination was unremarkable. He was planned for a barium swallow examination. The chest X-ray was normal. Spirometry was done for the evaluation of shortness of breath. The flow–volume loop [Figure - 1]a showed flattening of the expiratory limb of the loop suggesting intrathoracic variable airway obstruction. Subsequently, a contrast CT scan of the thorax was done [Figure - 1]b, which showed a large dilated oesophagus causing compression of the trachea. The patient’s symptoms were consistent with an oesophageal motility disorder, and on barium swallow, he was diagnosed as achalasia cardia with a large dilated oesophagus.

Figure 1: (a) Flow-volume loop obtained during spirometry showing flattening of expiratory limb; (b) mediastinal section (axial) of CT thorax showing deformed trachea due to compression from the dilated oesophagus

Airway compression in achalasia can occur due to pressure exerted by the massively dilated oesophagus over the posterior tracheal wall but is an uncommon presentation. This patient underwent endoscopic treatment for achalasia. The patient did not give consent for bronchoscopic examination to assess for placement of a silicone stent to stabilize the airway. He had marked relief in his dysphagia at 6 months of follow-up although no relief was reported in his cough.

Conflicts of interest. None declared

Fulltext Views

PDF downloads
Show Sections