Achalasia

Case contributed by Dr Mario Umana

Presentation

History of chronic alcohol abuse with long time chest pain, dysphagia and nocturnal cough.

Patient Data

Age: 60 years
Gender: Male
x_ray

Right paracardiac opacity without silhouette sign. Air-fluid level in the mediastinum.

Fluoroscopy

Severe dilation of the thoracic esophagus with a bird beak sign.

Case Discussion

This was a patient with a history of chronic alcohol abuse with long time chest pain, dysphagia and nocturnal cough. Findings are most suggestive of achalasia. There is a classic bird beak sign at the gastro-esophageal junction.

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