Case contributed by Dr Jan Frank Gerstenmaier


This patient presented with dysphagia and chest pains. He has never been to South America.

Patient Data

Age: 40-45 years
Gender: Male
Modality: X-ray

The gastric gas bubble is absent. Lungs appear normal. Heart and mediastinal contours appear normal.

Modality: Barium

Single and double contrast barium swallow show markedly delayed emptying of the oesophagus and smooth tapering of the distal oesophagus, compatible with failure of sphincter to relax.

Modality: CT

The oesophagus is dilated and distally there is smooth circumferential wall thickening. Fluid-fluid level is present in the oesophagus. There is no evidence of aspiration at this time. No lymphadenopathy.

Case Discussion

The thick-walled oesophagus was biopsied and there was no evidence of malignancy. As in most patients with achalasia, this case was idiopathic.

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Case Information

rID: 24937
Case created: 21st Sep 2013
Last edited: 23rd Sep 2015
Inclusion in quiz mode: Included

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