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Achalasia

Case contributed by Alexandra Stanislavsky
Diagnosis probable

Presentation

Recurrent chest infections.

Patient Data

Age: 15 years
Gender: Female
x-ray

There are prominent perihilar interstitial markings and patchy airspace opacification.  

ct

Grossly distended esophagus contains a large amount of food debris.  There are numerous small foci of airspace and groundglass opacification.  Given the appearance of the esophagus, the lung changes most likely reflect aspiration.

Fluoroscopy

Distended esophagus and bird beak appearance of the esophageal sphincter, in a pattern typical of achalasia.

Case Discussion

Typical fluoroscopic appearance of achalasia, with secondary aspiration seen on chest imaging.

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