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Sigmoid Esophagus on EGD

By Andrés Rodríguez Parra, MD @RodriguezParra_

#Sigmoid #Esophagus #EGD #endoscopy #clinical #achalasia
Sigmoid Esophagus ... _ #Sigmoid #Esophagus ... endoscopy #clinical #achalasia
Chicago Classification of Esophageal Motility Disorders
Achalasia
EGJ Outflow Obstruction
Distal Esophageal Spasm
Jackhammer Esophagus
Absent Contractility
Ineffective Motility
Rapid Contraction

#Chicago #Classification #Esophageal
Motility Disorders Achalasia ... Spasm Jackhammer Esophagus
Esophageal Motility Disorders
Obstructive Physiology: EGJ, Distal Esophagus
Distal Contractility: Hyper-contractile, Hypo-contractile
Type I achalasia, Type II achalasia, Type
Physiology: EGJ, Distal Esophagus ... Hypo-contractile Type I achalasia ... , Type II achalasia ... , Type Ill achalasia ... contractility, End-stage achalasia
Ivor Lewis Esophagectomy on Chest X-Ray aka Gastric Pull-up
Ivor Lewis procedure is a type of esophagectomy
joined to the esophagus ... remind you of Achalasia ... distinguish it from achalasia
Dysphagia - Differential Diagnosis Algorithm

Oropharyngeal Dysphagia 
Esophageal Dysphagia 
 • Upper 2/3 (striated muscle): stroke, NMJ
Sjogren, web • Mid esophagus ... scleroderma, MCTD, achalasia
Achalasia Classification Types - Barium Contrast Esophagram:
1) Spindle type (classic)
2) Flask type 
3) Sigmoid type
Response to
Achalasia Classification ... suggestive of end stage achalasia ... LES since the esophagus ... #Achalasia #Classification
Achalasia Summary

Epidemiology: 10 cases per 100,000 individuals

Defined by inadequate relaxation of the LES and aperistalsis
Primary or
Achalasia Summary ... Achalasia has an ... two-thirds of the esophagus ... • Jackhammer esophagus ... gastroenterology #esophageal #esophagus
There is displacement of the azygoesophageal line both superiorly an inferiorly.
There is an air-fluid level (arrow).
Combined
must be a dilated esophagus ... diagnosis was achalasia ... Radiology #CXR #Achalasia
Here we have a prior CXR of this patient.
The AP-film shows a right paratracheal mass.
The azygoesophageal
dilatation of the esophagus ... #CXR #CTChest #Achalasia ... DilatedEsophagus #Dilated #Esophagus
Oropharyngeal and Esophageal Causes of Dysphagia - Differential Diagnosis
Oropharyngeal Dysphagia
 • Neuromuscular causes: CVA/CNS tumor/ALS, Parkinson's,
of EG junction: Achalasia ... Hypercontractile Esophagus