Mediastinal Widening: An Unusual Presentation of Achalasia Cardia

Abstract

Achalasia typically presents with dysphagia and regurgitation of undigested food. Diagnosis is usually performed with esophageal manometry before macroscopic anatomical changes appear.However some patients do not consult with early symptoms. We present a 55-year old women whose diagnosis was suspected with chest-x-ray showing a striking bread crumb pattern enlargement of right upper mediastinum. Diagnosis was then confirmed with upper endoscopy and manometry. After the failiure of some previous treatments, surgery finally controlled the symptoms.