2024 Volume 57 Issue 2 Pages 60-66
The patient was a 67-year-old man who had been admitted to our hospital for an investigation of dysphagia 17 years earlier. Three strictures were found in the upper, middle, and lower esophagus of the chest, and we diagnosed esophageal achalasia and cicatricial stricture associated with esophagitis. Endoscopic dilatation was performed repeatedly, but the stenotic symptoms repeatedly improved and recurred．We judged that the condition would not improve, and thoracoscopic subtotal esophagectomy was performed. The pathological findings included infiltration of inflammatory cells into the Auerbach plexus and a decrease or disappearance of ganglion cells throughout the esophageal wall. A loss of nerve cells and hyperplasia of collagen fibers were observed in the three stenotic sites, but no malignant findings were observed. Numerous scarring ulcers were also present. It is thought that esophageal achalasia occurred first, and thereafter cicatricial stenosis occurred on the oral side due to repeated inflammation. The occurrence of multiple strictures associated with esophageal achalasia has not been previously reported, and therefore, this is considered to be an extremely rare condition.
