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

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


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.


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
Published: 21st Sep 2013
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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