Achalasia Differential Diagnoses

Updated: Nov 13, 2023
  • Author: Marco Ettore Allaix, MD, PhD; Chief Editor: Praveen K Roy, MD, MSc  more...
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Diagnostic Considerations

Cancer of the gastroesophageal junction

The invasion of the esophageal neural plexus by the tumor can cause nonrelaxation of the LES, thus mimicking achalasia. This condition is known as malignant pseudoachalasia. Since contrast radiography and endoscopy frequently fail to differentiate these two entities, patients with a presumed diagnosis of achalasia but who have a shorter duration of symptoms, greater weight loss, and a more advanced age and who are referred for minimally invasive surgery should undergo additional imaging studies, including endoscopic ultrasound and computed tomography with fine cuts of the gastroesophageal junction, to rule out cancer.

Differential Diagnoses