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Case contributed by Achira Dilanka
Diagnosis almost certain


Dysphagia in an elderly patient with Parkinson's disease.

Patient Data

Age: 82
Gender: Male

There are reduced primary contractions and tertiary contractions in the lower esophagus.  Mild dilatation of the upper esophagus is seen as poor relaxation of the lower oesophagal sphincter. Contrast is seen within the stomach in delayed images.


Case Discussion

Presbyoesophagus is described in elderly patients presenting with dysphagia or non-cardiac chest pain. Impaired reflex arc and reduced sensitivity are thought to be the pathology resulting in reduced primary contractions and impaired sphincter relaxation. Non-propulsive (tertiary) contractions are usually seen in the lower esophagus.

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