A report on Esophageal achalasia and Hiatal hernia

A chest X-ray showing achalasia ( arrows point to the outline of the massively dilated esophagus )
A drawing of a hiatal hernia
Transhiatal oesophagectomy specimen from a patient suffering from late-stage achalasia. Diverticulum at the left lower end of the oesophagus.
An axial CT image showing marked dilatation of the esophagus in a person with achalasia.
Schematic diagram of different types of hiatus hernia. Green is the esophagus, red is the stomach, purple is the diaphragm, blue is the HIS-angle. A is the normal anatomy, B is a pre-stage, C is a sliding hiatal hernia, and D is a paraesophageal (rolling) type.
"Bird's beak" appearance and "megaesophagus", typical in achalasia.
A large hiatal hernia on chest X-ray marked by open arrows in contrast to the heart borders marked by closed arrows
Schematic of manometry in achalasia showing aperistaltic contractions, increased intraesophageal pressure, and failure of relaxation of the lower esophageal sphincter.
This hiatal hernia is mainly identified by an air-fluid level (labeled with arrows).
Image of a stomach which has undergone Fundoplomy
Upper GI endoscopy depicting hiatal hernia
Upper GI endoscopy in retroflexion showing Type I hiatal hernia
A hiatal hernia as seen on CT
A large hiatal hernia as seen on CT imaging
A large hiatal hernia as seen on CT imaging

Meanwhile, manometry can determine the integrity of esophageal movements, and the presence of esophageal achalasia.

- Hiatal hernia

Due to the similarity of symptoms, achalasia can be mistaken for more common disorders such as gastroesophageal reflux disease (GERD), hiatus hernia, and even psychosomatic disorders.

- Esophageal achalasia
A chest X-ray showing achalasia ( arrows point to the outline of the massively dilated esophagus )

4 related topics with Alpha

Overall
Potential location of pain from a heart attack

Chest pain

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Pain or discomfort in the chest, typically the front of the chest.

Pain or discomfort in the chest, typically the front of the chest.

Potential location of pain from a heart attack
A blockage of coronary arteries can lead to a heart attack
Gastroesophageal reflux disease is a common cause of chest pain in adults

Achalasia, nutcracker esophagus, and other motility disorders of the esophagus

Hiatus hernia

The digestive tract, with the esophagus marked in red

Dysphagia

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Difficulty in swallowing.

Difficulty in swallowing.

The digestive tract, with the esophagus marked in red

Achalasia is a major exception to usual pattern of dysphagia in that swallowing of fluid tends to cause more difficulty than swallowing solids.

Hiatus hernia, especially paraesophageal type

Barium meal examination showing the stomach and duodenum in double contrast technique with CO2 as negative contrast medium

Upper gastrointestinal series

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Series of radiographs used to examine the gastrointestinal tract for abnormalities.

Series of radiographs used to examine the gastrointestinal tract for abnormalities.

Barium meal examination showing the stomach and duodenum in double contrast technique with CO2 as negative contrast medium
Barium follow through showing the small bowel
Enteroclysis in double contrast technique showing stenosis of the small intestine
Zenker's diverticulum as seen in a barium swallow examination
Barium in the lungs resulting from aspiration during a barium swallow

They are used to diagnose and monitor esophageal reflux, dysphagia, hiatus hernia, strictures, diverticula, pyloric stenosis, gastritis, enteritis, volvulus, varices, ulcers, tumors, and gastrointestinal dysmotility, as well as to detect foreign bodies.

Amongst the uses of barium swallow are: persistent dysphagia and odynophagia despite negative esophagogastroduodenoscopy (OGDS) findings, failed OGDS, esophageal motility disorder, globus pharyngis, assessment of tracheoesophageal fistula, and timed barium swallow to monitor the progress of esophageal achalasia therapy.

Diagram of a Nissen fundoplication.

Nissen fundoplication

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Diagram of a Nissen fundoplication.
A completed Nissen fundoplication

A Nissen fundoplication, or laparoscopic Nissen fundoplication when performed via laparoscopic surgery, is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia.

In contrast, surgery for achalasia is generally accompanied by either a Dor or Toupet partial fundoplication, which is less likely than a Nissen wrap to aggravate the dysphagia that characterizes achalasia.