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Vol. 14. Issue 2.
Pages 309-313 (March - April 2008)
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Vol. 14. Issue 2.
Pages 309-313 (March - April 2008)
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Acalasia do esófago: Diagnóstico diferencial de asma brônquica
Oesophagus achalasia: Differencial diagnosis of asthma
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Patrícia Bacellar1, Marta Silva1, Nélia Tinoco2, Francisco Costa2, Helena Rodrigues3
1 Interna Complementar Medicina Interna
2 Assistente Hospitalar de Pneumologia
3 Serviço de Pneumologia/Medicina Interna Hospital São João de Deus, S. A. Vila Nova de Famalicão, Portugal
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Resumo

O megaesófago secundário à acalasia é uma causa rara, porém potencialmente fatal de obstrução da via aérea. A etiologia permanece pouco esclarecida. O quadro clínico habitual consiste em disfagia, regurgitação, emagrecimento progressivo, sendo que em alguns casos a distensão esofágica pode ser assintomática e em raros casos os doentes apresentam como queixa principal estridor e dificuldade respiratória.

Os autores apresentam um caso clínico de uma jovem de 19 anos, com tosse, dispneia e dificuldade respiratória, em tratamento para asma brônquica. Devido a persistência da sintomatologia, foi efectuado novo estudo da função respiratória, compatível com obstrução intratorácica. A esofagomanometria confirmou o diagnóstico de volumosa acalasia do esófago.

Após a correcção cirúrgica, a sintomatologia desapareceu e houve uma melhoria significativa das provas funcionais respiratórias posteriormente realizadas.

A acalasia do esófago deveria ser considerada como um dos diagnósticos diferencias de obstrução da via aérea.

Palavras-chave:
Obstrução da via aérea
acalasia do esófago
asma brônquica
espirometria
Abstract

Megaoesophagus resulting from achalasia is a rare but serious cause of airway obstruction. The exact aetiology remains unclear.

Achalasia normally presents as weight loss, dysphasia and regurgitation but frequently considerable oesophageal distension can occur without complain and very rarely cause of achalasia presents with stridor or respiratory distress.

The authors presents a 19-year old young lady who had respiratory symptoms and had been treated as a cause of chronic asthma, was found by us to have oesophagus achalasia. She had complained of cough, dispneia and had a pulmonary function studies that showed a severe airway obstruction.

After surgery the symptoms disappeared and she had a marked improvement in the flow-volume curve.

Oesophagus achalasia should be considered as one of the differential diagnoses of airway obstruction.

Key-words:
Airway obstruction
achalasia
asthma
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Bibliografia
[1.]
S.P. Dunlop, S.P. Travis.
Achalasia presentig as acute stridor.
Eur J Gastroenterol Hepatol, 9 (1997), pp. 1125-1128
[2.]
H. Hay.
Rapidly development airway obstruction resulting from achalasia of the oesophagus.
Eur J Anaesthesiology, 17 (2000), pp. 398-400
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