Megaesophagus and Megaduodenum Found Incidentally on a Routine Chest Radiograph During a Health Examination

Intern Med. 2021 Jul 1;60(13):2039-2046. doi: 10.2169/internalmedicine.6324-20. Epub 2021 Feb 1.

Abstract

Chronic idiopathic intestinal pseudo-obstruction (CIIP) caused by impaired intestinal peristalsis leads to intestinal obstructive symptoms. A 20-year-old man had marked esophageal dilatation that was found incidentally on chest radiography during a health examination. Chest/abdominal contrast-enhanced computed tomography and endoscopy showed marked esophageal and duodenal dilatation without mechanical obstruction. Upper gastrointestinal series and high-resolution esophageal manometry revealed absent peristalsis in the dilated part. CIIP was suspected in the patient's father, suggesting familial CIIP. The patient likely had signs of pre-onset CIIP. This is the first case of suspected CIIP in which detailed gastrointestinal tract examinations were performed before symptoms appeared.

Keywords: chest radiograph; chronic idiopathic intestinal pseudo-obstruction; esophageal manometry; gastrointestinal motility disorder; gastrointestinal series; intestinal dilatation.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Duodenum / abnormalities
  • Esophageal Achalasia* / diagnostic imaging
  • Fetal Diseases
  • Humans
  • Intestinal Pseudo-Obstruction*
  • Male
  • Manometry
  • Urinary Bladder / abnormalities
  • Young Adult

Supplementary concepts

  • Megaduodenum