Diagnostic analysis and literature review of adult megaesophagus

Objective: To investigate the imaging features of megaesophagus, and to improve the understanding of the disease. Methods: The imaging data of a patient with megaesophagus was analyzed retrospectively and the literature review was performed. Results: Cervical MRI scan showed esophageal dilatation localized behind trachea and anterior to vertebral body, T₁WI showed hypointense and T₂WI showed hypointense. Neck and lung CT scan examination showed a significant expansion of the whole esophagus. The maximum diameter of expanding esophagus was about 7 cm. A lot of chyme were detected, and no obvious cardiac mass was found. The adjacent trachea and mediastinum were compressed, tracheobronchial stenosis was present. The contents of the mild expanding stomach could be seen. The barium showed punctate high density in the dilated esophagus and stomach on abdominal CT after taking barium meal. On esophageal barium meal examination, the whole esophagus showed marked uneven dilation and segmental cystic changes. The barium passed through the esophagus slowly. There were many wide air-liquid levels, food retention could be seen in the esophagus. The peristaltic wave of esophagus was soft, and the mucosal pattern was not clear but thickening. Conclusion The imaging features of megaesophagus are specific, and are helpful in making diagnosis. (authors)