Achalasia

Case contributed by Stefan Tigges
Diagnosis certain

Presentation

5 year history of chest pain and dysphagia.

Patient Data

Age: 50 years
Gender: Male
x-ray

Air and debris containing middle mediastinal "mass", likely a markedly dilated esophagus, is present, otherwise normal.

Fluoroscopy

The esophagus is markedly dilated with a "corkscrew" distal esophagus and failure of the lower esophageal sphincter to relax. Findings are typical of achalasia.

ct

The esophagus is dilated, but without an obstructing mass or mediastinal adenopathy.

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