Scleroderma with oesophageal cancer and peptic stricture
Long history of scleroderma. Barium swallow performed because of increasing dysphagia to solids.
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Images show food material within the upper thoracic oesophagus which is somewhat dilated. Distal to this there is a 5 cm irregular narrowing of the mid thoracic oesophagus with proximal shouldering. Beyond this there is a short segment of non-strictured oesophagus before there is another 5 cm segment of smooth luminal narrowing extending to the gastro-oesophageal junction.
Findings are consistent with oesophageal carcinoma of the mid thoracic oesophagus (irregular stricture) and peptic stricture of the lower oesophagus (smooth stricture). These are recognised complications of scleroderma due to chronic gastro-oesophageal reflux related to reduced lower oesophageal sphincter tone.