Achalasia in one-year-old male

Case contributed by Desiree Rassa Eshraghi

Presentation

Regurgitation upon feeding.

Patient Data

Age: 1 year
Gender: Male
Fluoroscopy

Esophagram

The esophagus is diffusely dilated and the lumen tapers rather abruptly at the lower end. The obstruction is incomplete as barium is evident in the stomach.

Inflammatory changes may be present in the right upper lobe of the lung, possibly secondary to aspiration. 

Case Discussion

The imaging features are those of achalasia, which literally translated means failure of cardia relaxation. Elongated tapering of the distal esophagus is not present and therefore, this is not likely an inflammatory stricture. There is no typical shelf-like deformity to suggest neoplasm.

Achalasia is usually treated by a Heller procedure (myotomy of the distal esophagus and cardia).

 

This case was submitted with supervision and input from:
Soni C. Chawla, M.D.
Clinical Professor
Department of Radiological Sciences
David Geffen School of Medicine at UCLA
Attending Pediatric Radiologist
Olive View - UCLA Medical Center

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