Rat's tail sign (esophagus)

Last revised by Dr Dalia Ibrahim on 01 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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