An Involuntary and Unexpected Treatment of Nutcracker Esophagus.

An Involuntary and Unexpected Treatment of Nutcracker Esophagus.

Ann Thorac Surg. 2017 Jun;103(6):e545-e547

Authors: Mege D, Benezech A, de Lesquen H, Vitton V, Thomas PA

Abstract
A 76-year-old woman complained of painful dysphagia and loss of weight. Esophagoscopy results were negative, whereas computed tomography (CT) disclosed a 25-mm mediastinal tumor without a connection to the esophagus. A diagnosis of nutcracker esophagus was made on high-resolution esophageal manometry. Peroral endoscopic esophageal myotomy failed to improve the symptoms. Right video thoracoscopy allowed resection of the tumor, which looked like a neurogenic tumor of the posterior mediastinum that developed from the right vagus nerve. The patient's dysphagia dramatically improved postoperatively. Because the pathologic examination disclosed a benign solitary fibrous tumor of the pleura, we hypothesize that the motility disorder would have been resolved by the unilateral vagotomy.

PMID: 28528063 [PubMed - in process]

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