Systemic sclerosis (scleroderma).In this patient with known systemic sclerosis, the barium swallow shows moderate esophageal dilatation; there is almost complete loss of peristalsis, but, unlike achalasia, the esophagogastric junction is seen to be wide open and, in the recumbent position, there is marked gastro-esophageal reflux. In patients in whom gastro-esophageal reflux results in a peptic stricture, the radiological findings may resemble achalasia.
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