Return of esophageal peristalsis in achalasia secondary to gastric cancer

• Published in: Digestive diseases and sciences Vol. 26; no. 11; pp. 1038 - 1044
• Main Authors: Menin, R, Fisher, R S
• Format: Journal Article
• Language: English
• Published: United States 01-11-1981
• Subjects: Adenocarcinoma - complications; Adenocarcinoma - surgery; Aged; Esophageal Achalasia - diagnosis; Esophageal Achalasia - etiology; Esophageal Achalasia - physiopathology; Esophagus - physiopathology; Follow-Up Studies; Gastrointestinal Motility; Humans; Male; Peristalsis; Remission, Spontaneous; Stomach Neoplasms - complications; Stomach Neoplasms - surgery
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/BF01314770

A 69-year-old white man developed progressive symptoms of dysphagia for solids and liquids and regurgitation of undigested food accompanied by a 12-kg weight loss over a 4-month period. Initially, radiographs of the esophagus and stomach were normal, but when repeated 4 months later, a diagnosis of achalasia was suggested. Esophageal manometry performed at that time demonstrated a motor abnormality of the esophagus and lower esophageal sphincter consistent with a diagnosis of achalasia. Upper endoscopy revealed a small ulcerated tumor in the cardia of the stomach. A biopsy specimen was interpreted as adenocarcinoma of the stomach. Surgical treatment included resection of the gastric tumor along with a 4-cm segment of the distal esophagus, resection of a collar of apparently uninvolved stomach, and esophagogastrostomy. Nine months following surgery the patient was restudied. An upper gastrointestinal roentgenogram demonstrated a return of esophageal caliber and configuration to normal. Manometry showed that esophageal contractions had reverted to a normal progressive, postdeglutition pattern throughout the length of the esophagus. This is the first report in which achalasia secondary to gastric adenocarcinoma was reversed after tumor resection.