Rat Tail Appearance of the GE Junction

The Common Vein Copyright 2008t

Ashley Davidoff MD

Definition

Rat Tail of the esophagus is the characeristic of shape of the GE junction caused by spasm of the LES, aperistalsis, and consequent dilatation of the esophagus.

Air Fluid Level  and Rat Tail Appearance of the LES in Achalasia

The single contrats barium swallow shows an air-fluid level is seen in the dilated esophagus.  (a) The hypertonic LES has a “rat-tail” appearance as seen in image b.  Intermittant opening of the LES allows a variable amount of food or fluid through into the stomach.

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

 

 

Rat Tail
32051c01 esophagus ganglion cells smooth muscle spasm hypertonic lower esophageal sphincter LES rat tail rat-tail dx achalasia of the cardia single contrast barium swallow Courtesy Ashley Davidoff MD

 

 

Achalasia
16316c esophagus ganglion cells smooth muscle spasm hypertonic lower esophageal sphincter LES rat tail rat-tail dx achalasia of the cardia single contrast barium swallow Courtesy Ashley Davidoff MD

Achalasia with Enormous Esophagus, Bezoar and Rat Tail Esophagus

A CTscan through the chest shows a huge esophagus filled with solid food. (a,b) A bezoar is included in the differential diagnosis.  In d the distal esophagus has a rat-tail appearance at the zone of transition.

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