Family case of achalasia cardia: Case report and review of literature

Figure 1 A timed barium esophagogram. A: Dilatation of esophagus (arrow), beak-like narrowing of LES (arrow); B: The third contractions of esophagus (arrow); С: In 20 min after swallowing of barium, almost two thirds of the barium can be seen in the esophagus.

Figure 2 A high resolution manometry. Type II achalasia (Chicago classification): Resting Pressure lower esophageal sphincter (LES) 37 mmHg, IRP4, Integrated Relaxation Pressure 20 mmHg, Lack of normal esophageal peristalsis in response to normal swallowing of water (arrow).

Figure 3 A timed barium esophagogram. А: A very severe dilatation of esophagus up to 11 cm and a coarse deformation of esophagus with lots of folds in the form of cascade (arrow); B: Lateral side, a severe dilatation and deformation of esophagus. The level of liquid in esophagus can be seen (arrow).

Figure 4 A pedigree of the family. Occurrence of achalasia with a vertical line of transmission (esophageal achalasia in 58-year-old daughter, 81-year-old mother and grandmother).