Esophageal obstruction secondary to a partially volvulated paraesophageal gastric herniation

Case contributed by Dr Prat-Matifoll

Presentation

84 year-old woman referring undetermined dysphagia, coughing and vomits after every ingestion.

Patient Data

Age: 84
Gender: Female

The first four slides of the fluoroscopy show the primary peristaltic wave (triggered by the swallowing center)  and the secondary peristaltic wave (induced by esophageal distension) to clear the esophagus of retained baritated-contrast agent. The result of the multiple esophageal peristaltic waves was a threadlike flow through the entrance of the gastric hernia.

The last two slides show the tertiary contractions (dysfunctional contractions). These contractions are nonperistaltic and are observed with increased frequency in elderly people.

Here we have a previously performed CT due to abdominal discomfort. 

We observe the large gastric hernia partially included in this study.

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Case information

rID: 39134
Published: 22nd Aug 2015
Last edited: 14th Aug 2019
System: Chest
Inclusion in quiz mode: Included

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