case_images: PMC4503585_01
case_images: High-resolution manometry study showing hypertensive, nonrelaxing lower esophageal sphincter and aperistaltic esophagus, but with relatively high-amplitude simultaneous pressure changes in the esophageal body.
case_images: CRIS2015-328970.001.jpg
case_images: PMC4503585_01_CRIS2015-328970.001.jpg
case_images: fig1
case_images: Her previous test results were reviewed and found to be consistent with type III achalasia (Figure 1).
case_images: Esophagram showing classic "bird's beak" tapering with distal narrowing of the esophagus at the gastroesophageal junction with hang-up of contrast.
case_images: CRIS2015-328970.002.jpg
case_images: PMC4503585_01_CRIS2015-328970.002.jpg
case_images: fig2
case_images: A injection and balloon dilation at her request (using the same dosage and balloon size as at the initial procedure), but the treatment provided only one month of relief. A subsequent barium esophagram revealed partially treated achalasia, with significant delay in esophageal emptying and a tapered lower esophagus ("bird's beak" sign) (Figure 2).