A 27-year-old female presented with dysphagia, regurgitation, and weight loss (15 kg) for 4 months. Examination revealed severe malnutrition (body mass index 10.3 kg/m
2) and pallor. An esophagoduodenoscopy revealed a dilated esophagus and resistance at the gastroesophageal junction. A timed barium esophagogram showed hold up of contrast with distal tapering (Fig.
1a–c). The diagnosis of type II achalasia was confirmed on high-resolution solid state (Sandhill Scientific, CO, USA) esophageal manometry (basal lower esophageal sphincter [LES] pressure 25 mmHg, integrated relaxation pressure [IRP] 66 mmHg, distal contractile integral [DCI] 1155 mmHg/cm/s) (Fig.
1d). In view of the short duration of symptoms and severe weight loss, a positron emission tomographic (PET) scan performed with a possibility of secondary achalasia showed metabolically active enhancing mucosal thickening in the entire colon without any fluorodeoxyglucose (FDG) avidity in the esophagus. Her fecal calprotectin was...
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AM, KM, AV, VA, VV, and UCG declare that they have no conflict of interest.
The authors are solely responsible for the data and the contents of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, or the printer/publishers are responsible for the results/findings and content of this article.
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