Achalasia - with bird beak sign
36 years old female with longstanding sensation of food "stuck in her chest" and halitosis.
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Rapid sequence fluoroscopic images from a barium esophogram reveals a persistently dilated esophagus with an air-fluid level at the lower esophagus and classic "bird-beaking" at the gastroesophageal (GE) junction, despite normal primary peristaltic waves.
Achalasia can be divided into primary and secondary (pseudoachalasia):
- primary achalasia is a smooth muscle motility disorder of the esophagus.
- secondary achalasia is abnormal stricturing of the gastroesophageal junction, such as tumor compression or Chagas disease.
Esophagram is important in the evaluation of motility, reflux, and aspiration
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- Gockel I, MüLler M, Schumacher J. Achalasia-a disease of unknown cause that is often diagnosed too late. Dtsch Arztebl Int. 2012;109 (12): 209-14. doi:10.3238/arztebl.2012.0209 - Free text at pubmed - Pubmed citation
- Chuah SK, Hsu PI, Wu KL et-al. 2011 update on esophageal achalasia. World J. Gastroenterol. 2012;18 (14): 1573-8. doi:10.3748/wjg.v18.i14.1573 - Free text at pubmed - Pubmed citation