Diagnosis and Monitoring of Achalasia Utilizing Point-of-Care Ultrasound (POCUS): A Case Report

Achalasia is a rare disorder affecting the esophagus, in which the lower esophageal sphincter (LES) is spastic and fails to relax, causing food retention. This leads to esophageal dilatation over time. The condition often presents late and is frequently not suspected, resulting in delayed diagnosis. Traditionally, it is diagnosed through manometry, which shows failure of relaxation of the LES, along with ineffective or absent peristalsis. Barium swallow imaging reveals the pathognomonic "rat's tail" sign and a dilated esophagus. We report an interesting case of achalasia that was initially suspected on chest radiography, diagnosed using point-of-care ultrasound (POCUS), and later confirmed with a computed tomography scan. The patient improved after two sessions of balloon dilation, and monitoring with POCUS showed improvement. This case highlights the potential role of POCUS in both the diagnosis of achalasia and in monitoring after treatment.