Presentation
Heller's myotomy several years prior. Weight loss and unable to eat normal sized meals. Hypokalemic.
Patient Data
The esophagus is grossly dilated with food residue from the cervical esophagus down to the gastro-esophageal junction.
Collapsed normal stomach.
Lungs clear.
Case Discussion
A gross example of achalasia, which was unresponsive to a Heller's procedure.
This degree of dilatation is typically even evident on a chest x-ray, due to widening of the mediastinal contour.
A barium swallow is conventionally undertaken which demonstrates adynamic motility in addition to a dilated esophagus and gastro-esophageal junction obstruction.