The Common Vein Copyright 2008
Achalasia
 Achalasia with Mass in the Right Upper and Right Lower Chest |
| 74233c02 mass mass effect on the trachea esophagus GE junction enlarged bezoar spasm incoordination dx achalasia of the esophagus space CXR plain X-ray barium swallow Courtesy Ashley Davidoff MD |
 Achalasia with Bezoar and Retained Pills |
| 74233c01 mass mass effect on the trachea esophagus GE junction enlarged bezoar spasm incoordination dx achalasia of the esophagus space CXR plain X-ray barium swallow Courtesy Ashley Davidoff MD |
 Achalasia with Enormous Esophagus, Bezoar and Rat Tail Esophagus |
| 74233c03 mass mass effect on the trachea esophagus GE junction enlarged bezoar spasm incoordination dx achalasia of the esophagus space CXR plain X-ray barium swallow Courtesy Ashley Davidoff MD |
  Gastric Pull Through |
| 76384 esophagus carcinoma cancer gastric pull through surgery treatment differential diagnosis dd dilated esophagus barium swallow Courtesy Ashley Davidoff MD 76386c01 |
  Gastric Pull Through |
| 76384 esophagus carcinoma cancer gastric pull through surgery treatment differential diagnosis dd dilated esophagus barium swallow Courtesy Ashley Davidoff MD 76386c01 |
Diagnosis
The diagnosis can be made using different modalities. After a complete and thorough history taking, a suspicion often leads to a barium study of upper endoscopy. A barium study would demonstrate a dilated esophagus, often with an air fluid level, and the tapered ?bird-beak? narrowing at the distal esophagus.
 Air Fluid Level and Rat Tail Appearance of the LES in Achalasia |
| Courtesy Ashley Davidoff MD 01245c code esophagus + fx dilated + fx air fluid level + CXR chest X-ray plain film + fx beak sign dx achalasia of the esophagus barium swallow upper GI UGI imaging radiology contrast X-Ray |
 Upstream Dilitation and Downstream Focal Narrowing and Thickening of the LES in Achalasia |
| 46561c01.800 esophagus stomach gastroesophageal junction fx enlarged esophagus megaesophagus fx dilated fx narrowing at the GE junction fx stenosis dx achalasia CTscan Davidoff MD |
 Upstream Dilitation and Downstream Focal Narrowing with Fluid and Debris Accumulation at the LES in Achalasia |
| 73473 esophagus Dilated esophagus with liquid and debris at a tight LES achalasia endoscopy Courtesy Joshua Namias |
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