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www.thelancet.com Vol 377 February 19, 2011 667
Clinical Picture
Lancet 2011; 377: 667
PublishedOnline
February 10, 2011
DOI:10.1016/S0140-
6736(10)60675-7
Department of Surgery,
Numazu City Hospital,
Numazu, Japan (I Hoshino MD,
T Fukunaga MD, Y Isozaki MD);
andDepartment of Radiology,
Numazu City Hospital,
Numazu, Japan (H Yokota MD)
Correspondence to:
Dr Isamu Hoshino,
Department of Surgery,
Numazu City Hospital,
Higashi Shiji 550, Numazu,
Shizuoka 410-0302, Japan
[email protected]
Corkscrew oesophagus on virtual endoscopy
Isamu Hoshino, Hajime Yokota, Toru Fukunaga,Yuka Isozaki.
A 52-year-old man visited our hospital to have a generalcheckup.
Routine gastrointestinal endoscopy showed atwisted lumen with a
corkscrew appearance in the distaloesophagus. No other abnormality
was identified(figure A). Our patient did not have any symptoms
ofdysphagia or retrosternal pain. A single-contrast
bariumexamination of his oesophagus confirmed a spiralstaircase
peristalsis and an absence of peristalsis in theoesophageal body.
CT of the mediastinum was done, andvirtual endoscopy of the
oesophagus showed the typical
features of corkscrew oesophagus (figure B). Althoughmanometry
might be necessary to diagnose corkscrewoesophagus, we did not
recommend this to our patientbecause his corkscrew oesophagus had
been diagnosed,without any previous symptoms. In the future,
ourpatient will need to be treated with drugs such as
musclerelaxants and anxiolytic agents, in conjunction witheither
antireflux therapy or surgical myotomy. Currently,we only advise
him not to consume cold fluids to preventthe development of
symptoms.
Figure: Corkscrew oesophagus
Gastrointestinal endoscopy showing twisted lumen in distal
oesophagus (A); Mediastinal CT and virtual endoscopy of the
oesophagus showing typical corkscrew
appearance (B).
BA
