Thymus carcinoma-associated motility disorders: achalasia and gastroparesis caused by myenteric ganglionitis

A 66 years old female, with a history of surgical removal of thymus carcinoma, presented with progressive dysphagy and severe vomiting. Endoscopy revealed dilated tubular oesophagus, retention oesophagitis, mycosis and cardiac stenosis, manometry proved achalasia. After two times pneumatic dilatation dysphagy resolved, but gastric distension and noisea occured caused by gastric retention with delayed gastric emptying. In the background of the symptoms gastroparesis was suggested, therefore pyloric botulinus toxin injections were performed. Afterwards gastric emptying improved. The case was complicated by normoch…