Achalasia

Case contributed by Hani Makky Al Salam
Diagnosis certain

Presentation

Dysphagia

Patient Data

Age: 80 years
Gender: Female
x-ray

Right paravertebral region elongated opacity that produce mass effect on the posterior wall of the trachea seen on the lateral projection.

Fluoroscopy

Huge dilatation of the esophagus, with tapering at the gastro-esophageal junction representing the bird beak sign. No shouldering or obstructing lesion is seen.

ct

Heterogenous and dependent contents seen in a dilated esophagus that produce mass effect on the heart and tracheobronchial tree.

Case Discussion

Achalasia is characterized by absent peristalsis of the esophagus and incomplete relaxation of the lower esophageal sphincter, resulting in marked dilatation and poor esophageal emptying.

 

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