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