Final Diagnosis -Insta and FB post

 

                  Final Diagnosis:

Achalasia with Megaesophagus (Advanced Stage).

🔍 Radiologic Evidence:

🩻 Chest X-ray (Image 3):



  • Shows a widened mediastinum with a long, tubular opacity.
  • Evidence of air-fluid level and mottled density, suggestive of retained food/debris in a dilated esophagus.
  • Esophagus appears greatly dilated, deviating slightly to the left — classic for chronic achalasia.

📸 CT Scan (Images 1 & 2 – Coronal and Sagittal):




  • Demonstrates a massively dilated esophagus filled with fluid, food debris, and gas.
  • No discrete mass or stricture is visible, helping rule out malignancy (pseudoachalasia).
  • The esophagus extends well below the carina, almost to the gastroesophageal junction, with a characteristic tapered narrowing at the LES ("bird beak" sign may be inferred on barium).

🧠 Clinical Correlation:

  • 10-year history of progressive dysphagia to both solids and liquids.
  • Worsening over the last 6 months, possibly due to increased food retention or secondary inflammation.
  • Typical presentation of end-stage achalasia, also called sigmoid esophagus in severe cases.

🚨 Key Points:

  • This is a classic teaching case of untreated or late-stage achalasia.
  • Must rule out esophageal carcinoma by endoscopy/biopsy, as pseudoachalasia can mimic this appearance.
  • These patients are at risk of aspiration, malnutrition, and esophageal rupture if untreated.


Comments

Post a Comment

Popular posts from this blog

FINAL DIAGNOSE CASE -.....

Image
  FINAL DIAGNOSE- CASE NO. (FB AND INSTA )                          (Myelitis Ossificans ) This lateral elbow X-ray shows a well-defined, rounded, calcified mass in the soft tissue anterior to the distal humerus and not attached to the bone. The characteristic zonal pattern of ossification —with a more radiolucent center and denser peripheral ossification—supports the diagnosis of:    Myositis Ossificans ✅ Key Radiological Features: Location : Soft tissue ( commonly post-traumatic ), not arising from bone. Zonal ossification : Peripheral mature bone with central lucency. Well-circumscribed lesion . No cortical destruction or periosteal reaction , helping to differentiate it from aggressive neoplasms like osteosarcoma. 🧠 Important Differentials: Osteosarcoma : Irregular margins, bone destruction, and central ossification (opposite of MO). Soft tissue sarcoma with calcification : Less organized...
Read more

FINAL DIAGNOSE CASE-8

Image
   FINAL DIAGNOSE CASE NO - 8 (FB and Insta )         Re port Format (Radiology case - 8) Patient Information Age/Sex : 50-year-old female Clinical History : Chronic chest pain, cough, and shortness of breath and mild fever..       HRCT Chest Report Summary Findings : Image -1  Left upper lobe shows evidence of fibrotic changes with architectural distortion and traction bronchiectasis. Image -2  Multiple air-filled cystic lesions suggestive of post-infectious cystic bronchiectasis .     Image -3 Subpleural thickening is noted in the posterior segments, especially on the left side. No evidence of active cavitary lesion or pleural effusion. Mild volume loss seen with mediastinal shift towords right side. Impression : Imaging features are consistent with post-tuberculous sequelae ( fibrosis, bronchiectasis, and cyst formation ). No evidence of active pulmonary tuberculosis at present. Recommend corre...
Read more