Achalasia

Case contributed by Morouj Shaggah
Diagnosis certain

Presentation

Chest pain and discomfort that worsens after having food.

Patient Data

Age: 60 years.
Gender: Male

Chest X-ray

x-ray
Frontal
Lateral
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Info

A large convex opacity overlaps the right mediastinum, causing anterior displacement and bowing of the trachea on the lateral view with air-fluid levelling and absent gastric bubble, suggesting achalasia.
The heart size appears within upper normal limits.

Chest CT

ct
This study is a stack
Axial C+
arterial phase
This study is a stack
Sagittal
liver window
This study is a stack
Coronal
liver window
This study is a stack
Coronal
lung window
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Info

The thoracic esophagus is markedly dilated, filled with fluid/food debris and shows smooth distal tapering without wall thickening or mass lesion, suggesting primary achalasia.

The lung appears clear with no evidence of aspiration.

Case Discussion

A gross example of achalasia without evident complications.

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