Diagnosis: Achalasia

Findings: Bird-beak narrowing as seen on this barium swallow study. The absence of air in the expected location of the gastric bubble on frontal radiograph is also seen here.

Key Points and Discussion: There is often loss of esophageal peristalsis and loss of relaxation of the LES – lower esophageal sphincter. As a result there is an obstructive process resulting in food stasis and marked proximal dilatation of the esophagus. The differential diagnosis is secondary achalasia or pseudochalasia from possible malignancy is also a diagnostic consideration.

Credit: Case submitted by Dr. Saeed Rad MD to radRounds Radiology Network