MYOTOMY FOR ESOPHAGEAL MUSCULAR HYPERTROPHY WITH EOSINOPHILIC INFILTRATION ASSOCIATED WITH TOXOCARIASIS REVEALED BY AN ESOPHAGEAL MOTOR DISORDER

We report the case of a 61-year-old man with an eosinophilic esophagit is with esophageal motor disorder associated with toxocariasis. He com plained of non cardiac chest pain and had eosinophilia leading to the detection of Toxocara canis infection. Pain persisted despite treatmen t of toxocariasis. Basal manometry was normal but ambulatory 24-hour m anometry-pHmetry showed diffuse esophageal spasm. Ultrasonography show ed a thickening of the esophageal musculature in the two inferior thir ds of the esophagus. After failure of treatment with sodium cromoglyca te steroids and esophageal dilatation, calcium antagonists were partia lly effective. A long esophageal myotomy was performed permiting the d isappearance of symptoms. The histological examination of a side myoto my biopsy showed an eosinophilic infiltration of the esophageal muscle layer. This observation leads to discuss the possible relation betwee n toxocariasis, the esophageal motor disorder and the eosinophilic inf iltration of the esophageal muscle layer.