Medical image of the week: massive esophagus

• Main Authors: Young JR, August DL
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2013-10-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: esophagus; achalasia; paramedistinal mass; bird beak deformity; dilated esophagus; CT scan; thoracic CT scan
• Online Access: http://www.swjpcc.com/imaging/2013/10/30/medical-image-of-the-week-massive-esophagus.html

No abstract available. Article truncated at 150 words. A 34 year-old male inmate presents with chest pain 10 years prior to admission. His prior chest x-ray shows only mild thickening of the right paraspinal stripe (Figure 1). Chest x-ray on admission 10 years later shows a large right mixed density paramediastinal mass silhouetting the right pulmonary artery and right paratracheal stripe (Figure 2). This was confirmed to be a massive esophagus on thoracic CT scan (Figure 3). The patient was eventually diagnosed with achalasia. A number of disorders can present with a massive esophagus including achalasia, esophagectomy with colonic interposition, scleroderma, esophageal carcinoma with stricture, and esophagitis with stricture (1). Diagnostic imaging findings using fluroscopy, CT and X-ray can help differentiate these disorders. A massive esophagus due to achalasia is smooth walled with symmetric tapering to a "bird-beak" deformity and a chest x-ray may initially be normal. Colonic interposition is evident by colonic haustra. A dilated esophagus due …