Achalasia with aspiration

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

Ex-smoker. 3 years history of cough and increasing shortness of breath.

Patient Data

Age: 25 years
Gender: Male
ct

Grossly dilated esophagus down to the GEJ with air-fluid level.

Multifocal, ill-defined peribronchial consolidations in both lungs, most pronounced in the upper lobes.

Focal cystic bronchiectasis involving the anterior segment of the right upper lobe.

No evidence of interstitial fibrosis.

Case Discussion

This patient presented without swallowing complaints. He had respiratory symptoms.

His symptoms relate to the sequalea of the achalasia - recurrent aspiration into his lungs. This is one of the recognized associated issues with this condition.

One can appreciate from the appearance of the esophagus on the CT how prone the patient would be to chronic aspiration pneumonia.

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