Chronic achalasia

Case contributed by Dr Catriona Reid

Presentation

Weight loss, weakness and cough.

Patient Data

Age: 87
Gender: Female
X-ray

Chest radiograph demonstrated a widened mediastinum with a mottled tubular structure demonstrated superiorly at the sternoclavicular joint extending down to the diaphragm.

CT

CT chest/abdomen/pelvis demonstrated gross distension of the entire oesophagus with food debris.

Barium

Barium swallow corroborated these findings and also demonstrated a narrowed distal oesophagus.

Case Discussion

The diagnosis of achalasia was confirmed on oesophagogastroduodenoscopy (OGD). The case provides an example of how achalasia can present on chest radiographs and highlights a differential for a widened mediastinum.

Case submitted by Dr Catriona Reid and Dr Alaa Ismail.

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Case information

rID: 48885
Case created: 28th Oct 2016
Last edited: 7th Aug 2017
Inclusion in quiz mode: Included

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