Achalasia

Case contributed by Mohammad Taghi Niknejad
Diagnosis almost certain

Presentation

Thoracoabdominal pain and dyspepsia

Patient Data

Age: 65 years
Gender: Male
Barium

Dilatation and stasis in esophagus with acute tapering at the lower esophageal sphincter and narrowing at the gastroesophageal junction. Tertiary esophageal contractions are also evident in distal half of the esophagus.

Case Discussion

Features are compatible with achalasia (primary achalasia) which is a failure of organized esophageal peristalsis causing impaired relaxation of the lower esophageal sphincter, and resulting in food stasis and often marked dilatation of the esophagus.

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