Acute respiratory failure in achalasia with megaesophagus

Introduction: Achalasia is one of the most common causes of dysphagia. Typical symptoms include difficulty in swallowing, regurgitation, weight loss, and chest pain. Megaesophagus is a complication of advanced achalasia. This condition rarely causes tracheal compression with acute dyspnea.

Case Presentation : A 51 years old man came to the emergency room and had complaints of intermittent shortness of breath accompanied by a cough for 1 week, chest pain that came and went, nausea (+), vomiting (+), difficulty in swallowing food, and fever (-). The medical history showed that the patient went to gastroenterology polyclinic to examine his dysphagia and esophageal sphincter dilatation 2 months ago. The patient received treatment in the ward, but the complaints he suffered was getting worse, so he was transferred to the ICU with a diagnosis of acute respiratory failure.

Conclusion: The patient was then intubated and decompressed for the megaoesophagus he suffered with the aim to reduce the compression of the trachea and lungs by the esophagus. The patient was getting better and could be extubated on the 3rd day of treatment.