A case of esophageal achalasia presenting with chronic cough diagnosed with high-resolution manometry
Hirohito Sanoa Shun Yamanakaa Tomotaka Shojib Tomomi Machidac Shin Fukudob,d Hisatoshi Sugiuraa
aDepartment of Respiratory Medicine, Tohoku University Graduate School of Medicine
bDepartment of Psychosomatic Medicine, Tohoku University Hospital
cDepartment of Psychosomatic Medicine, Tohoku Rosai Hospital
dDepartment of Behavioral Medicine, Tohoku University Graduate School of Medicine
A 61-year-old man presented to our hospital because of chronic cough. Chest X-ray showed esophageal dilation and left diaphragm elevation caused by enlargement of the gastric bubble. We made a diagnosis of esophageal achalasia because high-resolution manometry showed impaired esophagogastric junction relaxation and the absence of normal peristalsis. We analyzed 10 cases of esophageal achalasia, including this case, which had chronic cough at the first visit to the hospital. It was revealed that these cases showed more weight loss and less dysphagia compared with common esophageal achalasia and, in many cases (89%), esophageal dilation could be detected by imaging. It is important for clinicians to consider esophageal achalasia as a possible differential diagnosis when a patient presents with chronic cough.
Chronic cough Esophageal achalasia Left diaphragm elevation
Received 14 Aug 2020 / Accepted 2 Dec 2020
AJRS, 10(2): 191-196, 2021