Pseudoachalasia

Case contributed by Mohammadtaghi Niknejad
Diagnosis certain

Presentation

Work up for dysphagia.

Patient Data

Age: 65 years
Gender: Male
Fluoroscopy

Barium has passed through the pharynx, and relative dilatation along with stasis of the contrast media are evident in the esophageal lumen. Stricture with irregular margins can be seen in the distal esophagus and proximal stomach suggesting pseudoachalasia, and in favor of tumoral infiltration. 

ct

Increased wall thickness suggestive of tumoral infiltration is present at gastric cardia and proximal lesser curvature, accompanied by several regional enlarged lymph nodes with a maximum SAD of 30 mm.

The prostate gland is enlarged. 

Case Discussion

Pathology proved esophagogastric adenocarcinoma

The term pseudoachalasia refers to achalasia-pattern dilatation of the esophagus due to narrowing of the distal esophagus from causes other than primary denervation. One of the most common causes is a malignancy with extension in the lower esophagus. On barium swallow, more marked mucosal irregularity of malignant lesions could be seen in pseudoachalasia.

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