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Achalasia

Case contributed by Prof Oliver Hennessy

Presentation

Increasing dysphagia.

Patient Data

Age: 65 years
Gender: Female
X-ray

The esophagus is grossly dilated and measures up to 10 cm in diameter. There is an air fluid level projected at the level of the posterior third rib. These findings are in keeping with the known history of achalasia. There is displacement of the trachea to the right with significant narrowing of the trachea, best appreciated in the lateral projection.

 

Case Discussion

This is primary achalasia in this patient. CT and barium swallow showed no evidence of extrinsic compression of the distal esophagus.

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