Case Report

Vigorous achalasia: Zebra amongst horses

Jayaranjeetham Jayabalan, Nithin Theckumparampil, Aravintho Natarajan, Dilip S. Phansalkar, George Kurian
South African Journal of Radiology | Vol 24, No 1 | a1953 | DOI: https://doi.org/10.4102/sajr.v24i1.1953 | © 2020 Jayaranjeetham Jayabalan, Nithin Theckumparampil, Aravintho Natarajan, Dilip S. Phansalkar, George Kurian | This work is licensed under CC Attribution 4.0
Submitted: 21 July 2020 | Published: 30 November 2020

About the author(s)

Jayaranjeetham Jayabalan, Department of Radiodiagnosis, Pondicherry Institute of Medical Sciences, Puducherry, India
Nithin Theckumparampil, Department of Radiodiagnosis, Pondicherry Institute of Medical Sciences, Puducherry, India
Aravintho Natarajan, Department of Radiodiagnosis, Pondicherry Institute of Medical Sciences, Puducherry, India
Dilip S. Phansalkar, Department of Radiodiagnosis, Pondicherry Institute of Medical Sciences, Puducherry, India
George Kurian, Department of Gastroenterology, Pondicherry Institute of Medical Sciences, Puducherry, India


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Abstract

Vigorous achalasia is an oesophageal disorder with clinical and radiological characteristics of classic achalasia and diffuse oesophageal spasm. It is a rarely reported variant. A 60-year-old gentleman presented with complaints of difficulty in swallowing, regurgitation and chest pain for the past 10 years. His symptoms persisted despite the use of proton pump inhibitors. On endoscopy and barium swallow, the diagnosis of vigorous achalasia was confirmed. It is a rare variant of classic achalasia usually misdiagnosed as diffuse oesophageal spasm.

Keywords

vigorous achalasia; diffuse oesophageal spasm; classic achalasia; barium swallow; proton pump inhibitors.

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