Presentation
Dysphagia more to solid food
Patient Data
Age: 60 years
Gender: Male
From the case:
Epiphrenic divericulum associated with oesopahgeal achalasia
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Large wide necked diverticulum arising from the distal esophagus above the left hemidiaphragm, and this is associated with tapering of the inferior esophagus (Rat's tail sign) and consequent dilatation of the esophagus, prominent tertiary waves are also noted along the esophagus.
Case Discussion
Rat tail's sign of distal esophagus is characteristic of achalasia, however any contour irregularity or extension beyond the esophagus should raise the possibility of oseopahgeal carcinoma causing secondary achalasia.
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