Spontaneous Opening of LES in Achalasia: an Uncommon onLine Documentation by HighResolution Manometry - Abstract
The case reported is related to a 72 years old female patient, with a long-lasting
clinical history of dysphagia and retrosternal discomfort. Endoscopic and radiologic
exams were strongly suggestive for achalasia and high resolution manometry was
scheduled to confirm the diagnosis. A type I achalasia was documented, with absent
peristalsis throughout the esophageal body and not-relaxing lower esophageal
sphincter. Throughout the procedure a progressive increase of the intraesophageal
pressure after the subsequent wet swallows was recorded, the patient experiencing
concomitant retrosternal discomfort. Once spontaneous opening of the LES region
occurred not related to deglutition the esophageal pressure suddenly decreased, with
significant symptoms relief by the patient. The manometric images seem to offer a clear
documentation of the motor abnormalities underlying clinical pattern in end stage type
I achalasia.