Abnormal esophageal motility in the elderly.
irrespective of the kind of motility disorder.
Diffuse esophageal spasm.
Dilated esophagus with poor peristalsis.
Achalasia of the
Atrophy of the
by fibrous tissue.
Barium swallow / vidofluroscopy:
Dilated esophagus with smooth tapering of its
lower end giving bird beaks appearance.
Absent primary peristalsis.
Repitive (>30%) tertiary non propulsive
contractions giving cork screw appearance.
Asymptomatic esophageal Weak primary peristalsis.
motility disorder in elderly. Tertiary contractions with cork screw esophagus.
Dilated atonic lower 2/3 of the esophagus (smooth
Normal motility of the upper 1/3 (striated muscles).
Patulous lower esophageal sphincter with GERD.
Granular mucosal pattern.
Shallow ulcers in the distal esophagus.
Transverse fixed mucosal folds (step ladder
Buckering & sacculations.
• 2ry achalasia (e.g esophageal carcinoma or
• Reflux esophagitis, with stricture.
Markedly dilated esophagus
(> 4 cm in its maximum diameter).
Short narrow segment (< 3.5 cm)
Secondary achalasia (pseudoachalasia)
Mildly dilated esophagus
(less than 4 cm in its maximum diameter).
Long narrow segment (> 3.5 cm)
2ry achalasia after Nissen
Barrot beak appearance
Reflux esophagitis with
Smooth tapering of the distal esophageal segment.
Associated with aperistalsis.
Associated with hiatus hernia.
Gross dilatation of the
Rarely associated with gross