{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T13:10:10Z","timestamp":1745759410521,"version":"3.40.4"},"reference-count":6,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2015,1,4]]},"abstract":"<jats:p>An 18-year-old man presented to primary care with a 2-year history of exclusively nocturnal \u2018noisy breathing\u2019. He was otherwise asymptomatic. He had never smoked and was previously healthy. Spirometry showed a severely obstructive picture with forced expiratory volume in 1\u2005s (FEV1) 1.87\u2005L (44% predicted), forced vital capacity (FVC) 4.0\u2005L (80%) and FEV1\/FVC ratio of 47%. A diagnosis of asthma was suspected and a trial of inhaled bronchodilators and corticosteroids was initiated. Failure to improve symptoms led to referral to the Respiratory Clinic, where his mother replayed a recording of the \u2018noisy breathing\u2019 on her mobile phone. Subsequent examination revealed a stridor on expiration. Flow volume loop showed a plateau of the expiratory limb, consistent with intrathoracic upper airway obstruction. CT of the thorax revealed a massively dilated oesophagus, filled with food residue, reflecting an achalasia, causing lower tracheal compression. He is now being considered for a myotomy procedure.<\/jats:p>","DOI":"10.1136\/bcr-2014-206106","type":"journal-article","created":{"date-parts":[[2015,3,10]],"date-time":"2015-03-10T12:12:03Z","timestamp":1425989523000},"page":"bcr2014206106","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["\u2018Nocturnal noises\u2019: an isolated stridor in an adolescent"],"prefix":"10.1136","volume":"2015","author":[{"given":"K I","family":"Zalewska","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G F A","family":"Benfield","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,3,10]]},"reference":[{"key":"2025042705395618000_2015.mar10_1.bcr2014206106.1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcp073"},{"key":"2025042705395618000_2015.mar10_1.bcr2014206106.2","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1111\/j.1440-1843.2008.01395.x","article-title":"Achalasia cardia presenting as stridor","volume":"13","author":"Wechalekar","year":"2008","journal-title":"Respirology"},{"key":"2025042705395618000_2015.mar10_1.bcr2014206106.3","first-page":"1097","article-title":"Stridor from tracheal obstruction in a patient with achalasia","volume":"88","author":"Panzini","year":"1993","journal-title":"Am J Gastroenterol"},{"key":"2025042705395618000_2015.mar10_1.bcr2014206106.4","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-199711000-00019"},{"key":"2025042705395618000_2015.mar10_1.bcr2014206106.5","first-page":"12","article-title":"Life-threatening acute airway obstruction in achalasia","volume":"6","author":"Wagh","year":"2004","journal-title":"MedGenMed"},{"key":"2025042705395618000_2015.mar10_1.bcr2014206106.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.anpedi.2010.12.003"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2014-206106","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T12:40:04Z","timestamp":1745757604000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2014-206106"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,3,10]]},"references-count":6,"alternative-id":["10.1136\/bcr-2014-206106"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2014-206106","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2015,3,10]]}}}