Achalasia of the cardia
Dysphagia for solids for 9 months.
CT Chest and CT Abdomen
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CT chest, abdomen with Oral and IV contrast:
Gross distension of the entire oesophagus down to be the gastroesophageal junction, consistent with achalasia.
No obvious evidence of complicating oesophageal carcinoma. No mediastinal lymphadenopathy.
Lung fields are unremarkable with no evidence of chronic aspiration.
In the abdomen the appearances are unremarkable.
The case shows typical achalasia of the cardia with oesophageal dilatation and tortuosity due to the failure of relaxation of the lower oesophageal sphincter possibly due to degeneration of myenteric Auerbach's Plexus. The main differential diagnosis is 2ry achalasia due to lower oesophageal or gastroesophageal carcinoma (pseudoachalasia).