Achalasia complicated by carcinoma
The barium swallow in this case shows generalized esophageal dilatation, loss of peristalsis, and a cigar-shaped distal end, in keeping with achalasia. In addition, however, there is an annular stricture of the esophagus several centimetres above the distal end. Endoscopic biopsy confirmed carcinoma. The association between achalasia and cancer varies; but, in one study of 1,318 patients, the risk of carcinoma was found to be 2.7 - fourteen times greater than that in the general population.
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