Achalasia

Case contributed by Dr Derek Smith

Presentation

Admitted with shortness of breath. Previously investigated for ?dysphagia. Few bibasal crackles on auscultation. ?pneumonia ?fluid overload

Patient Data

Age: 60
Gender: Male
X-ray

Distended esophagus with gas/fluid level at the level of the carina.

Chronic left basal changes. No focal consolidation or lobar collapse.

Normal heart size with normal pulmonary vascularity. Pleural spaces clear.

Fluoroscopy

Previous barium swallow

Double-contast study:

Distended atonic esophagus with relaxed lower esophageal sphincter.

No mass or stricture.

Case Discussion

This patient had advanced achalasia which was an incidental finding on the admission CXR.

No features of aspiration which these patients are at higher risk of.

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Case information

rID: 49713
Published: 16th Jan 2017
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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