Rat's tail sign (oesophagus)

Last revised by Dalia Ibrahim on 1 Aug 2022

The rat's tail sign refers to tapering of the inferior oesophagus on barium swallow study. Many sources use this sign synonymously with the ​bird beak sign (oesophagus) and indicate that it is characteristic of achalasia 1. It is important to remember that if a "rat tail" involves more than just the distal oesophagus and/or has contour irregularity, then this raises the possibility of oesophageal carcinoma (i.e. pseudoachalasia).

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