A Strange Case of Esophageal Dysmotility and Neck Swelling in a Lupus Patient

Arjavon Talebzadeh

Department of Emergency Medicine, Orange Park Medical Center, USA

^*Correspondance to: Arjavon Talebzadeh 

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Abstract:

Achalasia is a disorder of esophageal dysmotility characterized by impaired lower esophageal sphincter (LES) relaxation, resulting in poor passage of food bolus into the stomach. Gastrointestinal manifestations are frequently observed in systemic rheumatologic conditions, including systemic lupus erythematosus (SLE). This is a report of a middle-aged female with SLE who presented with sudden-onset dysphagia and anterior neck swelling. Imaging revealed a massively dilated, air-filled esophagus with associated anterior tracheal displacement. Although manometry showed a normal integrated relaxation pressure (IRP) of 12 mmHg—technically falling short of formal achalasia diagnosis per Chicago Classification v4.0—the patient demonstrated 100% failed swallows, absent contractility, and panesophageal pressurization. She underwent pneumatic dilation and later laparoscopic Heller myotomy with Dor fundoplication with significant improvement. This case illustrates an atypical esophageal dysmotility pattern in an SLE patient, highlighting the need to consider sigmoid esophagus with air trapping in patients presenting with concurrent dysphagia and anterior neck swelling.

Keywords:

Achalasia; Lupus; Dysmotility; Esophagus; Manometry

Cite the Article:

Talebzadeh A. A Strange Case of Esophageal Dysmotility and Neck Swelling in a Lupus Patient. World J Surg Surgical Res. 2026; 9: 1619..