• Clin Med (Lond) · Jan 2024

    Case Reports

    A complex case of dysphagia with dual aetiology.

    • Catherine Sykes, Matthew Banks, Humayra Dervin, Andres Vales, and Rami Sweis.
    • Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK.
    • Clin Med (Lond). 2024 Jan 1; 24 (1): 100010100010.

    AbstractA woman in her early 60s was referred with dysphagia and chest pain to a tertiary referral centre specialising in oesophageal disorders. Cardiac symptom origin and sinister oesophageal pathology had been excluded at her local hospital in NHS Scotland. Under multidisciplinary team oversight, reinvestigation of mucosal pathology and oesophageal motility ultimately uncovered both Type III achalasia and eosinophilic oesophagitis. This case demonstrates the benefit of including provocative testing during high-resolution manometry to reproduce relevant dysphagia and the importance of stopping proton-pump inhibitors long enough to uncover excessive eosinophils which could otherwise be masked. Ultimately, tailored management for both conditions separately was required to achieve symptoms resolution.Copyright © 2023. Published by Elsevier Ltd.

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