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-70

Image
      Radiology case-70 (FB and INSTA) POST Final Diagnosis: -  Intracranial Hemangiopericytoma 📸 Imaging Modality: MRI Brain with Contrast (T1-weighted axial view) 🩻 Radiological Findings: Well-defined extra-axial mass with strong, heterogeneous contrast enhancement Broad-based dural attachment but without calcification No dural tail sign (unlike meningioma) May show flow voids due to high vascularity Causes mass effect with midline shift or perilesional edema Often located in parasagittal or convexity regions. Hemangiopericytoma is a rare but aggressive dural-based tumor . Unlike meningiomas, it is more vascular , more likely to recur , and has metastatic potential . ✅ Case confirmed by imaging features and histopathological correlation.
Read more

TRIPLE PHASE CT SCAN

Image
                  TRIPLE PHASE CT SCAN A Triple Phase CT Scan is a specialized imaging technique primarily used to evaluate vascular structures and organ perfusion , especially in the liver, pancreas, kidneys , and certain tumors. It involves acquiring CT images in three different phases of contrast enhancement after intravenous contrast injection. 🔹 Definition : A Triple Phase CT scan is a contrast-enhanced CT examination that captures images in three time-based phases following contrast injection: Arterial Phase (~20–30 sec) Portal Venous Phase (~60–70 sec) Delayed Phase (~5–15 mins) It provides detailed vascular and parenchymal evaluation, particularly useful for detecting hypervascular and hypovascular lesions. 🔹 Indications: Triple phase CT is commonly indicated in: Liver lesion characterization (e.g., HCC, metastases, hemangiomas ) Preoperative liver surgery planning Hepatic arterial mapping Pancreatic masses Renal t...
Read more