Achalasia

Case contributed by Dr Ahmad Syauqi

Presentation

Dysphagia to solids and liquids, with food residue found in the esophagus during upper endoscopy.

Patient Data

Age: 40 years
Gender: Male

Barium Swallow

Barium

Diffuse esophageal dilatation due to contrast delay at the lower esophageal sphincter, with smooth, short segment tapering resembling a bird's beak.

In supine position, esophageal dilatation and tertiary contractions can be appreciated.

Case Discussion

The patient's history, upper endoscopy, and barium swallow findings point toward achalasia, a primary disorder of the both the lower esophageal sphincter and of esophageal motility. Manometry would be confirmatory.

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