贲门失弛缓症手术后20年并发食管癌实属罕见,现报告一例如下。患者男性,45岁。于1965年无任何诱因出现间歇性吞咽困难,饭后胸骨后有食物滞留感。X线钡餐检查:贲门处对称性狭窄呈鸟嘴样,狭窄以上食管扩张约5cm。诊断为贲门失弛缓症,于1971年11月20日行Heller氏手术。术后恢复顺利,16天出院,出院后饮食恢复正常。1991年1月19日因进食梗噎,胸骨后灼痛1个月第二次入院。X线钡餐检查:上中段食管粘膜皱襞紊乱,充盈缺损,僵硬,长约6cm。食管镜检查:距门齿25cm～30cm食管后壁可见肿物高低不平,向腔内生长,表面有污秽苔,组织脆,易出血.病理检查;食管粘膜结构消失,可见大量增生间变之鳞状细胞,核分裂像可见,提示食管鳞状细胞癌。诊断:贲门失弛缓症远期并发 Esophageal cancer complicated by achalasia for 20 years after surgery is rare, and one case is reported below. The patient is male, 45 years old. In 1965, there was no cause of intermittent dysphagia and there was a feeling of food retention after the sternum. X-ray barium meal examination: Symptoms of symmetry at the fontanelle were beak-like, and esophageal dilation was more than 5 cm above the stenosis. The diagnosis of achalasia was performed on November 20, 1971 with Heller’s surgery. She recovered smoothly after surgery and was discharged in 16 days. She returned to normal after discharge. On January 19, 1991, he was hospitalized for the second time after he had suffered a burning pain in the sternum. X-ray barium meal examination: upper and middle esophageal mucosal folds disorder, filling defect, stiff, about 6cm. Esophagoscopy: From the incisors 25cm to 30cm, the posterior wall of the esophagus shows unevenness in the mass, which grows into the cavity with contaminated moss on the surface. The tissue is brittle, and it is prone to bleeding. Pathological examination; esophageal mucosal structure disappears, and a large number of proliferative squamas can be seen. Cells, mitotic figures visible, suggesting esophageal squamous cell carcinoma. Diagnosis: Long-term concurrent achalasia