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There is displacement of the azygoesophageal line both superiorly an inferiorly.
There is an air-fluid level (arrow).
Combined
diagnosis was achalasia ... result from prior aspiration ... Radiology #CXR #Achalasia ... AirFluidLevel #Aspiration
Here we have a prior CXR of this patient.
The AP-film shows a right paratracheal mass.
The azygoesophageal
the result of aspiration ... #CXR #CTChest #Achalasia ... Dilated #Esophagus #Aspiration
Oropharyngeal Dysphagia 
 • due to motor disorders affecting the pharyngeal muscles
 • Acute or gradual
underlying disorder • Aspiration ... Scleroderma • Achalasia
Dysphagia - Differential Diagnosis Framework

Symptom | Diagnosis
• Solid-food dysphagia present for months to years | Mechanical
disorder such as achalasia ... malignancy Risk for aspiration
Pathophysiology Of Constriction
Exaggerated Ventricular Interdependence:
 • Limited Cardiac Filling due to Fixed Volume → Septum Shifts
Filling During Inspiration ... /Expiration • ... pressure with respiration ... With inspiration ... With inspiration
Gastroenterology Endoscopy Tools and Accessories - A Visual Catalog for Trainees and Young Gastroenterologists
Biopsy Forceps:
ports to allow aspiration ... Management: • ACHALASIA ... patients with achalasia ... Used to prevent aspiration
Achalasia Management Algorithm
 - Botulinum Injection
 - Pharmacotherapy (CCB/nitrates)
 - Pneumatic Dilation
 - Peroral Endoscopic Myotomy
Achalasia Management ... Esophagectomy #Achalasia
Paradoxic Breathing in Pediatric Respiratory Distress - Improved after nebulizers and HFNC

Inward chest wall movement with
movement with inspiration ... movement with expiration
Body Fluid Aspiration and Interpretation
 - Arthrocentesis
 - Paracentesis
 - Thoracentesis
 - Lumbar Puncture

Dr. Sarah Foohey
Body Fluid Aspiration ... #Body #Fluid #Aspiration
Ivor Lewis Esophagectomy on Chest X-Ray aka Gastric Pull-up
Ivor Lewis procedure is a type of esophagectomy
remind you of Achalasia ... distinguish it from achalasia