Grave difficulties swallowing both food and liquids.
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Dilated esophagus with smooth distal tapering giving the parrot beak appearance.
Achalasia is a oesophageal motility disorder due to failure of relaxation of the lower oesophageal sphincter. This occurs due to an abnormality within the Auerbach's plexus - be it primary or secondary.
Baruim swallow demonstrates:
- Beaked tapering of the oesophagus at the gastro-oesophgeal junction
- A grossly dilated oesophagus
- Tertiary contractions
- Air-fluid level on the control/plain film
- Achalasia is associated with an increased risk of oesophageal malignancy
- Beware of pseudoachalasia due to destruction of the plexus by tumour such as linitis plastica
- The radiologist has a role in treatment by ballon dilatation
Image courtesy of Dr Ian Bickle