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Esophageal achalasia

Case contributed by Fazel Rahman Faizi
Diagnosis almost certain

Presentation

Vomiting.

Patient Data

Age: 3 years
Gender: Female
Fluoroscopy

This is a barium meal study.

Non-specific bowel gas pattern is noted in the reference picture.

The esophagus is significantly dilated showing a tapering end of the distal part giving the bird-beak appearance.

The stomach was opacified with the contrast showing normal outlines.

Normal passage of contrast was noted through the pylorus into the stomach. No evidence of pyloric stenosis.

Normal opacification of the duodenum. No evidence of intestinal malrotation.

Case Discussion

Esophageal achalasia can be seen in children as early as 5 months up to 16 years old. Dysphagia and vomiting are common complaints. Barium contrast study of the esophagus is the initial diagnostic modality.

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