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Esophageal Achalasia
Michael P. Federle, MD, FACR
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Cardiospasm
          • Definitions

            • Primary esophageal motility disorder due to defective neural stimulation of lower esophageal sphincter

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Gross Pathologic & Surgical Features

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Teitelbaum EN et al: Symptomatic and physiologic outcomes one year after peroral esophageal myotomy (POEM) for treatment of achalasia. Surg Endosc. ePub, 2014
                                      2. Richter JE: Update on the management of achalasia: balloons, surgery and drugs. Expert Rev Gastroenterol Hepatol. 2(3):435-45, 2008
                                      3. Williams VA et al: Achalasia of the esophagus: a surgical disease. J Am Coll Surg. 208(1):151-62, 2009
                                      4. Sabharwal T et al: Balloon dilation for achalasia of the cardia: experience in 76 patients. Radiology. 224(3):719-24, 2002
                                      5. Vaezi MF et al: Timed barium oesophagram: better predictor of long term success after pneumatic dilation in achalasia than symptom assessment. Gut. 50(6):765-70, 2002
                                      6. Adler DG et al: Primary esophageal motility disorders. Mayo Clin Proc. 76(2):195-200, 2001
                                      7. Woodfield CA et al: Diagnosis of primary versus secondary achalasia: reassessment of clinical and radiographic criteria. AJR Am J Roentgenol. 175(3):727-31, 2000
                                      8. de Oliveira JM et al: Timed barium swallow: a simple technique for evaluating esophageal emptying in patients with achalasia. AJR Am J Roentgenol. 169(2):473-9, 1997
                                      9. Noh HM et al: CT of the esophagus: spectrum of disease with emphasis on esophageal carcinoma. Radiographics. 15(5):1113-34, 1995
                                      10. Schima W et al: Esophageal motor disorders: videofluoroscopic and manometric evaluation--prospective study in 88 symptomatic patients. Radiology. 185(2):487-91, 1992
                                      11. Frankhuisen R et al: Functional dyspepsia and irritable bowel syndrome in patients with achalasia and its association with non-cardiac chest pain and a decreased health-related quality of life. Scand J Gastroenterol.
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Pathology

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Synonyms

                                                • Cardiospasm
                                              • Definitions

                                                • Primary esophageal motility disorder due to defective neural stimulation of lower esophageal sphincter

                                              IMAGING

                                              • General Features

                                                • Radiographic Findings

                                                  • CT Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          • Gross Pathologic & Surgical Features

                                                            • Microscopic Features

                                                              CLINICAL ISSUES

                                                              • Presentation

                                                                • Demographics

                                                                  • Natural History & Prognosis

                                                                    • Treatment

                                                                      DIAGNOSTIC CHECKLIST

                                                                      • Consider

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Teitelbaum EN et al: Symptomatic and physiologic outcomes one year after peroral esophageal myotomy (POEM) for treatment of achalasia. Surg Endosc. ePub, 2014
                                                                          2. Richter JE: Update on the management of achalasia: balloons, surgery and drugs. Expert Rev Gastroenterol Hepatol. 2(3):435-45, 2008
                                                                          3. Williams VA et al: Achalasia of the esophagus: a surgical disease. J Am Coll Surg. 208(1):151-62, 2009
                                                                          4. Sabharwal T et al: Balloon dilation for achalasia of the cardia: experience in 76 patients. Radiology. 224(3):719-24, 2002
                                                                          5. Vaezi MF et al: Timed barium oesophagram: better predictor of long term success after pneumatic dilation in achalasia than symptom assessment. Gut. 50(6):765-70, 2002
                                                                          6. Adler DG et al: Primary esophageal motility disorders. Mayo Clin Proc. 76(2):195-200, 2001
                                                                          7. Woodfield CA et al: Diagnosis of primary versus secondary achalasia: reassessment of clinical and radiographic criteria. AJR Am J Roentgenol. 175(3):727-31, 2000
                                                                          8. de Oliveira JM et al: Timed barium swallow: a simple technique for evaluating esophageal emptying in patients with achalasia. AJR Am J Roentgenol. 169(2):473-9, 1997
                                                                          9. Noh HM et al: CT of the esophagus: spectrum of disease with emphasis on esophageal carcinoma. Radiographics. 15(5):1113-34, 1995
                                                                          10. Schima W et al: Esophageal motor disorders: videofluoroscopic and manometric evaluation--prospective study in 88 symptomatic patients. Radiology. 185(2):487-91, 1992
                                                                          11. Frankhuisen R et al: Functional dyspepsia and irritable bowel syndrome in patients with achalasia and its association with non-cardiac chest pain and a decreased health-related quality of life. Scand J Gastroenterol.