A Rare Coexistence: Achalasia Esophagus and Acute Intestinal Pseudo-Obstruction

TL;DR

This paper reports a rare case of a 96-year-old woman with two uncommon digestive disorders, achalasia esophagus and acute intestinal pseudo-obstruction, and discusses their possible shared causes.

Contribution

The novelty lies in documenting the rare coexistence of two distinct motility disorders and suggesting potential shared pathophysiological mechanisms.

Findings

A 96-year-old patient exhibited symptoms of both achalasia esophagus and acute intestinal pseudo-obstruction.

Diagnostic imaging confirmed esophageal dilation and bowel dilation without mechanical obstruction.

The case raises questions about shared mechanisms in the enteric nervous system or smooth muscle dysfunction.

Abstract

Achalasia esophagus and acute intestinal pseudo-obstruction are distinct gastrointestinal motility disorders rarely found together in the same patient. We present a case of a 96-year-old woman exhibiting symptoms of both conditions, including dysphagia, regurgitation, abdominal distension, nausea, vomiting, and constipation. Diagnostic evaluations revealed esophageal dilation with a "bird beak" sign on timed barium swallows and significant bowel dilation without mechanical obstruction on computed tomography scans. Treatment involved conservative measures for acute intestinal pseudo-obstruction and palliative approaches for achalasia esophagus. The coexistence of these disorders raises questions about potential shared pathophysiological mechanisms involving the enteric nervous system or smooth muscle dysfunction. Further research is warranted to elucidate these connections and improve management strategies for such complex cases.

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