Pediatric Achalasia

  • Etiology: Contraction of lower esophageal sphincter
  • Imaging UpperGI: Dilated fluid-filled esophagus that terminates in a narrow bird’s beak above the gastroesophageal junction
  • DDX:
  • Complications: Aspiration pneumonia
  • Treatment: Esophageal dilation or surgery
  • Clinical:

Radiology Cases of Achalasia

CXR and upper GI of achalasia
CXR PA and lateral (above) shows a dilated esophagus with an air-fluid level within it. AP and lateral images from an upper GI (below) show an extremely dilated esophagus with fluid-fluid level within it that terminates in a beak at the gastroesophageal junction.
Upper GI of achalasia
Three lateral images from an upper GI exam shows dilation of the proximal esophagus which narrows to a beak distally which never opens up. A barium pill would not pass through the distal esophagus into the stomach.