❗️Medical Case #1 - Difficulty Breathing

📖 Case: A 45 year old male presenting with difficulty swallowing both solids and liquids. A barium swallow showed the image below: ⁣

👨🏻‍⚕️Diagnosis⁣

Achalasia - failure of organized esophageal peristalsis causing impaired relaxation of the lower esophageal sphincter and marked dilatation of the esophagus.

This may initially present with difficulty swallowing liquids that progresses to solids. This may also be accompanied by early satiety and unintentional weight loss.

Long standing complications including risk of aspiration pneumonia from constant debris in the esophagus and esophageal carcinoma from chronic irritation of the esophageal lining. ⁣

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🔍 Symptoms⁣

🔹 Dysphagia (difficulty swallowing to both solids AND liquids)⁣

🔹 Chest pain/ discomfort⁣

🔹 Regurgitation⁣

🔹 Weight loss⁣

💡 Diagnostics⁣

▪️ Barium study showing “bird-beak” narrowing of distal esophagus⁣

▪️ Confirmed via endoscopy⁣

🏥 Treatment⁣

🔸Lifestyle changes - eat slowly, increase water intake with meals, & avoid eating at bedtime⁣

🔸Pneumatic dilatation - effective in up 90% of patients⁣

🔸Botulinum toxin injection⁣

🔸Surgical myotomy⁣

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Case Images courtesy of Dr Naim Qaqish / radiopaedia.org⁣

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