Achalasia

Case contributed by Dr Derek Smith

Presentation

Admitted with shortness of breath. Previously investigated for ?dysphagia. Few bibasal crackles on auscultation. ?pneumonia ?fluid overload

Patient Data

Age: 60 years
Gender: Male
x_ray

Distended esophagus with gas/fluid level at the level of the carina.

Chronic left basal changes. No focal consolidation or lobar collapse.

Normal heart size with normal pulmonary vascularity. Pleural spaces clear.

Previous barium swallow

Fluoroscopy

Double-contast study:

Distended atonic esophagus with relaxed lower esophageal sphincter.

No mass or stricture.

Case Discussion

This patient had advanced achalasia which was an incidental finding on the admission CXR.

No features of aspiration which these patients are at higher risk of.

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