Case contributed by Ian Bickle


Heller's myotomy several years prior. Weight loss and unable to eat normal sized meals. Hypokalemic.

Patient Data

Age: 35 years
Gender: Male

The esophagus is grossly dilated with food residue from the cervical esophagus down to the gastro-esophageal junction.

Collapsed normal stomach.

Lungs clear.

Case Discussion

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 esophagus and gastro-esophageal junction obstruction.

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