Diffuse esophageal spasm

Case contributed by Mohammad Taghi Niknejad
Diagnosis almost certain

Presentation

Odynophagia.

Patient Data

Age: 50 years
Gender: Male
Barium

There is uncoordinated peristalsis in the thoracic esophagus with simultaneous contraction of the esophagus at multiple points also known as corkscrew esophagus or rosary bead esophagus. 

 

Case Discussion

Features are suggestive of diffuse/distal esophageal spasm (DOS) which is a motility disorder of the esophagus. On barium swallow, DOS may appear as a corkscrew or rosary bead esophagus, but this is uncommon. Manometry is the gold-standard diagnostic test. 

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