Primary achalasia - timed barium esophagogram

Case contributed by Mohammadtaghi Niknejad


Work up for long standing dysphagia.

Patient Data

Age: 65 years
Gender: Male

Diffuse esophageal dilatation up to 45 mm with distal tapering at the level of the lower esophageal sphincter is suggestive of achalasia.
On timed barium esophagogram, serial images were taken in 1, 3, and 5 minutes and showed oral contrast media stasis. The height and width of the barium column are decreased relatively on the delayed images.

Case Discussion

Primary achalasia is a failure of organized esophageal peristalsis accompanied by impaired relaxation of the lower esophageal sphincter, causing food stasis and luminal dilatation, most frequently seen in middle and late adulthood and usually idiopathic.

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