Korean J Neurogastroenterol Motil.  2003 Dec;9(2):159-162.

Reversible Diffuse Esophageal Spasm in a Patient with Secondary Hypoadrenocorticism

• Joo HS
• Hong SJ
• Park JH
• Cho WY
• Yang JH
• Lee JH
• Kim HY
• Ko BM
• Ryu CB
• Cho JY
• Lee JS
• Lee MS
• Shim CS
• Kim BS

Abstract

A forty two year-old female patient came to our hospital due to chest pain and difficulty in swallowing. She presented with dysphagia for solids and liquids. Endoscopic findings showed chronic gastritis with bile reflux and remnant food material. Esophageal manometry revealed 28.6% simultaneous contractions and a high esophageal sphincter pressure that completely relaxed with wet swallows. Esophagography showed intermittent loss of primary peristalsis after barium swallow. Her esophageal problem was diagnosed as diffuse esophageal spasm. On neurologic examination, she had right quadrianopsia and left hemianopsia. She was subsequently diagnosed as pituitary adenoma with secondary hypoadrenocorticism on the basis of radiological examination, surgical pathology, and hormonal studies. The patient was treated with 7.5 mg prednisone per day, and, within 2 weeks, dysphagia had markedly improved. After 1 month, dysphagia had disappeared and her esophageal manometric findings returned to normal.

Keyword

Diffuse esophageal spasm; Hypoadrenocorticism

MeSH Terms

Barium
Bile Reflux
Chest Pain
Deglutition
Deglutition Disorders
Esophageal Spasm, Diffuse*
Female
Gastritis
Hemianopsia
Humans
Manometry
Neurologic Examination
Pathology, Surgical
Peristalsis
Pituitary Neoplasms
Prednisone
Swallows
Barium
Prednisone