Achalasia differential diagnosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Achalasia]] | |||
{{CMG}}, {{AE}} {{AY}} | {{CMG}}, {{AE}} {{AY}} | ||
==Overview== | ==Overview== | ||
Achalasia must be differentiated from other causes of dysphagia, odynophagia and food regurgitation such as [[GERD]], [[Esophageal carcinoma|esophageal adenocarcinoma]] | Achalasia must be differentiated from other causes of [[dysphagia]], [[odynophagia]] and food [[regurgitation]] such as [[GERD]], [[Esophageal carcinoma|esophageal adenocarcinoma]], [[esophageal stricture]], [[esophageal webs]], [[motor disorders]] such as [[myasthenia gravis]], [[stroke]], [[Zenker's diverticulum]], [[diffuse esophageal spasm]], [[systemic sclerosis]] and [[Plummer-Vinson syndrome|Plummer Vinson syndrome]]. | ||
== Differentiating Achlasia from other Disease== | == Differentiating Achlasia from other Disease== | ||
Achalasia must be differentiated from other causes of [[dysphagia]], [[odynophagia]] and food regurgitation such as [[GERD]], [[Esophageal carcinoma|esophageal adenocarcinoma]] and [[esophageal stricture]]. | Achalasia must be differentiated from other causes of [[dysphagia]], [[odynophagia]] and food regurgitation such as [[GERD]], [[Esophageal carcinoma|esophageal adenocarcinoma]] and [[esophageal stricture]]. | ||
<small> | <small> | ||
{| class="wikitable" | {| class="wikitable" | ||
! rowspan="3 | ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Disease | ||
! colspan="8 | ! colspan="8" style="background:#4479BA; color: #FFFFFF;" align="center" |Signs and Symptoms | ||
! rowspan="3 | ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Barium esophagogram | ||
! rowspan="3 | ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Endoscopy | ||
! rowspan="3 | ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Other imaging and laboratory findings | ||
! rowspan="3 | ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold Standard | ||
|- | |- | ||
| rowspan="2 | | rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Onset | ||
| colspan="3 | | colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Dysphagia | ||
| rowspan="2 | | rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss | ||
| rowspan="2 | | rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Heartburn | ||
| rowspan="2 | | rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Other findings | ||
| rowspan="2 | | rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Mental status | ||
|- | |- | ||
| | | style="background:#4479BA; color: #FFFFFF;" align="center" |Solids | ||
| style="background:#4479BA; color: #FFFFFF;" align="center" |Liquids | |||
| style="background:#4479BA; color: #FFFFFF;" align="center" |Type | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Plummer-Vinson syndrome]] | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Plummer-Vinson syndrome]] | ||
Line 340: | Line 341: | ||
|} | |} | ||
<small> | <small> | ||
{| class="wikitable" | {| class="wikitable" | ||
Line 425: | Line 425: | ||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category:Otolaryngology]] | [[Category:Otolaryngology]] | ||
[[Category:Differential diagnosis]] | |||
{{WS}} | {{WS}} | ||
{{WH}} | {{WH}} | ||
<references /> |
Latest revision as of 01:58, 24 August 2021
![](/images/1/16/Home_logo1.png)
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]
Overview
Achalasia must be differentiated from other causes of dysphagia, odynophagia and food regurgitation such as GERD, esophageal adenocarcinoma, esophageal stricture, esophageal webs, motor disorders such as myasthenia gravis, stroke, Zenker's diverticulum, diffuse esophageal spasm, systemic sclerosis and Plummer Vinson syndrome.
Differentiating Achlasia from other Disease
Achalasia must be differentiated from other causes of dysphagia, odynophagia and food regurgitation such as GERD, esophageal adenocarcinoma and esophageal stricture.
Disease | Signs and Symptoms | Barium esophagogram | Endoscopy | Other imaging and laboratory findings | Gold Standard | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Onset | Dysphagia | Weight loss | Heartburn | Other findings | Mental status | |||||||
Solids | Liquids | Type | ||||||||||
Plummer-Vinson syndrome |
|
+ | - | Non progressive | +/- | - | Normal |
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{{#ev:youtube|HFfsTgsB6Pg}}
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Triad of | |
Esophageal stricture |
|
+ | - | Progressive | +/- | +/- | Normal |
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{{#ev:youtube|vax5E-jMnQ}}
|
|
||
Diffuse esophageal spasm |
|
+ | + | Non progressive | + | + | Normal |
![]() Source:By Nevit Dilmen [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0) |
{{#ev:youtube|2ipA34iMA3c}}
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|
||
Achalasia |
|
+ | + | Non progressive | +/- | - |
|
Normal |
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{{#ev:youtube|ydLcskQzEjM}}
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||
Systemic sclerosis |
|
+ | + | Progressive | +/- | + |
|
Normal |
|
|
Positive serology for | |
Zenker's diverticulum |
|
+ | - | +/- | - |
|
Normal |
![]() |
{{#ev:youtube|FdEruFsNdVA}}
|
| ||
Esophageal carcinoma |
|
+ | + | Progressive | + | +/- | Normal |
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{{#ev:youtube|5ucSlgqGAno}}
|
|||
Stroke |
|
+ | + | Progressive | + | +/- |
|
Impaired |
|
|
||
Motor disorders |
|
+ | + | Progressive | +/- | Normal |
|
|
|
| ||
GERD |
|
+ | - | Progressive | +/- | + | Normal |
|
|
| ||
Esophageal web |
|
+ | +/- | Progressive | - | +/- |
|
Normal |
|
|
|
|
Manifestations | Diagnostic tools | |
---|---|---|
Achalasia |
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GERD |
|
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Esophageal carcinoma |
|
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Corckscrew esophagus |
|
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Esophageal stricture |
|
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Plummer-Vinson syndrome | Common symptoms of Plummer-Vinson syndrome include[9][10][11]
Less cmmon symptoms
|
![]() |
References
- ↑ Ferri, Fred (2015). Ferri's clinical advisor 2015 : 5 books in 1. Philadelphia, PA: Elsevier/Mosby. ISBN 978-0323083751.
- ↑ 2.0 2.1 2.2 Boeckxstaens GE, Zaninotto G, Richter JE (2013). "Achalasia". Lancet. doi:10.1016/S0140-6736(13)60651-0. PMID 23871090.
- ↑ Badillo R, Francis D (2014). "Diagnosis and treatment of gastroesophageal reflux disease". World J Gastrointest Pharmacol Ther. 5 (3): 105–12. doi:10.4292/wjgpt.v5.i3.105. PMC 4133436. PMID 25133039.
- ↑ 4.0 4.1 Napier KJ, Scheerer M, Misra S (2014). "Esophageal cancer: A Review of epidemiology, pathogenesis, staging workup and treatment modalities". World J Gastrointest Oncol. 6 (5): 112–20. doi:10.4251/wjgo.v6.i5.112. PMC 4021327. PMID 24834141.
- ↑ Matsuura H (2017). "Diffuse Esophageal Spasm: Corkscrew Esophagus". Am. J. Med. doi:10.1016/j.amjmed.2017.08.041. PMID 28943381.
- ↑ Lassen JF, Jensen TM (1992). "[Corkscrew esophagus]". Ugeskr. Laeg. (in Danish). 154 (5): 277–80. PMID 1736462.
- ↑ Ruigómez A, García Rodríguez LA, Wallander MA, Johansson S, Eklund S (2006). "Esophageal stricture: incidence, treatment patterns, and recurrence rate". Am. J. Gastroenterol. 101 (12): 2685–92. doi:10.1111/j.1572-0241.2006.00828.x. PMID 17227515.
- ↑ Shami VM (2014). "Endoscopic management of esophageal strictures". Gastroenterol Hepatol (N Y). 10 (6): 389–91. PMC 4080876. PMID 25013392.
- ↑ López Rodríguez MJ, Robledo Andrés P, Amarilla Jiménez A, Roncero Maíllo M, López Lafuente A, Arroyo Carrera I (2002). "Sideropenic dysphagia in an adolescent". J. Pediatr. Gastroenterol. Nutr. 34 (1): 87–90. PMID 11753173.
- ↑ Chisholm M (1974). "The association between webs, iron and post-cricoid carcinoma". Postgrad Med J. 50 (582): 215–9. PMC 2495558. PMID 4449772.
- ↑ Larsson LG, Sandström A, Westling P (1975). "Relationship of Plummer-Vinson disease to cancer of the upper alimentary tract in Sweden". Cancer Res. 35 (11 Pt. 2): 3308–16. PMID 1192404.