Chagas disease - megaesophagus

Diagnosis certain

Presentation

Progressive dysphagia for over 15 years.

Patient Data

Age: 50 years
Gender: Male

Before the barium esophagram

Annotated image

Frontal radiograph demonstrates right inferior mediastinal widening. Lateral radiograph shows an air-fluid level and a retrocardiac mass. 

Before the barium esophagram

Annotated image

Frontal radiograph demonstrates right inferior mediastinal widening (purple arrows). Lateral radiograph shows an air-fluid level (green arrow) and a retrocardiac mass (orange arrows). 

Esophagram

Barium

The radiographs demonstrate the progression of the barium. There is marked tapering of the distal esophagus, a dilated and tortuous esophagus, as well as tertiary contractions and an air-fluid level.

Case Discussion

A barium swallow exam is useful for studying a wide range of pathologies, such as motility disorders. In this case the patient had a diagnosis of Chagas disease for almost 15 years and he has been under specialized care already for a long time. His symptoms progressively worsened throughout time despite conservative treatments.

Contributed by Dr. Guilherme Pioli Resende M.D. and Dr. Marcello Antônio de Rezende Basilio M.D.

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