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Achalasia Secondary to Carcinoma: Manometric and Clinical Features
- HAROLD J. TUCKER, M.D.;
- WILLIAM J. SNAPE, Jr., M.D., F.A.C.P.; and
- SIDNEY COHEN, M.D., F.A.C.P.
Abstract
The clinical and diagnostic features of a secondary type of achalasia of the esophagus are described in seven patients with various types of malignancies. Patients with secondary achalasia presented with dysphagia of short duration and marked weight loss; mean age was 64 years. Esophageal manometry showed features identical to those of idiopathic primary achalasia: aperistalsis, poor lower esophageal sphincter relaxation, and elevated sphincter pressure. Endoscopy and barium swallow showed evidence of a tumor in only two cases. Various types of malignancies may produce a secondary form of achalasia that has diagnostic features identical to those of primary achalasia and is best identified by its clinical presentation.
Article and Author Information
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▸From the Gastrointestinal Section, Department of Medicine, University of Pennsylvania at the Hospital of the University of Pennsylvania; Philadelphia, Pennsylvania.
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Grant support: in part by Training Grant T32 AM07066 from the National Institutes of Health, Bethesda, Maryland.
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▸Requests for reprints should be addressed to Sidney Cohen, M.D.; Gastrointestinal Section, Hospital of the University of Pennsylvania, Box 652; 3400 Spruce Street; Philadelphia, PA 19104.
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- Received February 22, 1978.
- Accepted May 5, 1978.
- © 1978 American College of Physicians
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