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CT evaluation of achalasia
L S Rabushka1, E K Fishman, J E Kuhlman
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD 21205.
Journal of Computer Assisted Tomography
|May 1, 1991
Summary
Computed tomography (CT) effectively identifies achalasia, showing esophageal dilatation. CT can also reveal atypical features, aiding diagnosis of other esophageal conditions and complications.
Area of Science:
- Radiology
- Gastroenterology
Background:
- Achalasia is a primary esophageal motility disorder.
- Accurate diagnosis is crucial for management and preventing complications.
Purpose of the Study:
- To evaluate the utility of computed tomography (CT) in diagnosing achalasia.
- To identify CT findings that differentiate achalasia from other esophageal diseases.
Main Methods:
- Retrospective review of CT scans from 12 patients with suspected achalasia.
- Analysis of esophageal diameter, wall thickness, and presence of complications.
Main Results:
- Nine patients had confirmed achalasia, exhibiting moderate to marked esophageal dilatation (mean diameter 4.35 cm) with normal wall thickness.
- Three patients with pseudoachalasia, benign stricture, and leiomyomatosis showed atypical dilatation and/or wall thickness.
- Complications in achalasia patients included secondary carcinoma, esophageal perforation, and aspiration.
Conclusions:
- CT findings in achalasia are distinct from other esophageal pathologies.
- CT is valuable for diagnosing achalasia, especially in complex cases.
- CT can detect atypical features suggesting alternative diagnoses or superimposed conditions.