Presbyoesophagus

Case contributed by Dr Chris O'Donnell

Presentation

Long-standing symptoms of dysphagia and heartburn.

Patient Data

Age: 85 years
Gender: Female

Chest

X-ray

Gas-filled distension of the esophagus in the posterior mediastinum (arrows) associated with a hiatus hernia.

Barium swallow

Fluoroscopy

Dilated, patulous esophagus throughout its length with poor contractility/peristalsis and a sliding hiatus hernia. No stricture such as achalasia.

Case Discussion

Presbyoesophagus is a controversial diagnosis and is probably not just due to old age but associated with chronic reflux and hiatus hernia (that is more commonly seen in the elderly). It is characterized by a dilated esophagus showing poor contractility or tertiary contractions but no stricture. It is a cause of dysphagia in the elderly.

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