Presentation
Severe dysphagia and recent weight loss.
Patient Data
Dilatation and contrast media stasis are seen in the esophageal lumen, with irregular long segment distal narrowing inferring pseudoachalasia.
Case Discussion
This case typically demonstrates the radiological appearance of pseudoachalasia, also known as secondary achalasia, an achalasia-pattern dilatation of the esophagus due to the narrowing of the distal esophagus from causes other than primary denervation. One of the most common causes is a malignancy, often submucosal gastric cancer with extension in the lower esophagus and distal esophageal carcinoma with involvement of the esophagogastric junction. On barium swallow, there is usually more marked mucosal irregularity of malignant lesions in pseudoachalasia compared to the primary achalasia.
The patient underwent an endoscopy and biopsy, which confirmed esophageal adenocarcinoma.
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