Achalasia (timed esophagogram)

Case contributed by Dr Mohammad Taghi Niknejad

Presentation

Dysphagia.

Patient Data

Age: 35 years
Gender: Male
Barium

Dilatation and stasis in esophagus with acute tapering at the lower esophageal sphincter and narrowing at the gastro-esophageal junction with characteristic appearances of bird beak sign or  rat-tail sign. On timed esophagogram contrast stasis are persistent on dilated esophagus after 5 minutes.

Case Discussion

Features are consistent with 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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