Rat's tail sign (esophagus)

Last revised by Dalia Ibrahim on 1 Aug 2022

The rat's tail sign refers to tapering of the inferior esophagus on barium swallow study. Many sources use this sign synonymously with the ​bird beak sign (esophagus) 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 esophagus and/or has contour irregularity, then this raises the possibility of esophageal carcinoma (i.e. pseudoachalasia).

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Cases and figures

  • Figure 1: photograph - rat's tail
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  •  Case 1
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  • Case 2
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  • Case 3
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  • Case 4
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