Achalasia

Case contributed by Bruno Di Muzio

Presentation

Chronic dysphagia.

Patient Data

Age: 80 years
Gender: Female

Chest radiographs

x_ray

Esophagus is grossly dilated. Heart silhouette is enlarged. Mediastinal contours are otherwise unremarkable. 

Lungs and pleural spaces are clear. 

Barium Swallow

Fluoroscopy

Marked dilated and tortuous esophagus. Oral contrast passes with some pooling/stasis of barium that is associated with incomplete lower esophageal sphincter relaxation (beak-like appearance). There is a failure of coordinated esophageal contractions - non-propulsive contractions/failure of normal peristalsis

Case Discussion

Imaging features of achalasia.

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