Heller's myotomy several years prior. Weight loss and unable to eat normal sized meals. Hypokalaemic.
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The oesophagus is grossly dilated with food residue from the cervical oesophagus down to the gastro-oesophageal junction.
Collapsed normal stomach.
A gross example of achalasia, which was unresponsive to a Heller's procedure.
This degree of dilatation is typically even evident on a chest x-ray, due to widening of the mediastinal contour.
A barium swallow is conventionally undertaken which demonstrates adynamic motility in addition to a dilated oesophagus and gastro-oesophageal junction obstruction.