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Achalasia

Case contributed by: Dr Frank Gaillard
From the case: Achalasia
Modality: X-ray
  • <p>Achalasia</p>

Achalasia

Case Discussion:

This women in her 20's presented with grave difficulties swallowing both food and liquids.

Achalasia is a oesophageal motility disorder due to failure of relaxation of the lower oesophageal sphincter. This occurs due to an abnormality within the Auerbach's plexus - be it primary or secondary.

Baruim swallow demonstrates:

  1. Beaked tapering of the oesophagus at the gastro-oesophgeal junction
  2. A grossly dilated oesophagus
  3. Tertiary contractions
  4. Air-fluid level on the control/plain film

Key Points:

  1. Achalasia is associated with an increased risk of oesophageal malignancy
  2. Beware of pseudoachalasia due to destruction of the plexus by tumour such as linitis plastica
  3. The radiologist has a role in treatment by ballon dilatation

Image courtesy of Dr Ian Bickle

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