End Stage Achalasia Cardia Masked by Chest Trauma: A Case of Diagnostic Mimicry

Background: Achalasia is the commonest primary esophageal motility disorder. Long standing achalasia reaches the end-stage form when the oesophagus becomes dilated and tortuous and often amenable only to esophagectomy. At this stage the diagnosis may not be straight forward. Our objective is to emphasise the need for detailed evaluation of chest trauma patients who may have coincidental background chest diseases such as end-stage Achalasia.
Case Report: We report a 52 year old lady with end-stage achalasia who presented elsewhere with blunt chest trauma and the radiographic features were misdiagnosed as the sequelae of the chest trauma or a chest tumour and then referred to us. Thorough evaluation led to the diagnosis of the end-stage Achalasia and she successfully underwent transhiatal esophagectomy.
Conclusion: There is need for detailed evaluation of chest trauma patients and high index of suspicion for concomitant conditions should be demonstrated to prevent complications and improve the patients’ outcome.