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 oesophagus, with tapering at the gastro-oesophageal junction representing the bird beak sign. No shouldering or obstructing lesion is seen.

ct

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

Case Discussion

Achalasia is characterised by absent peristalsis of the oesophagus and incomplete relaxation of the lower oesophageal sphincter, resulting in marked dilatation and poor oesophageal emptying.

 

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