case_images: PMC9897699_01
case_images: Computed tomography angiography of the chest and abdomen showing markedly dilated esophagus (Eso) against the left atrium (LA) in coronal (A) and sagittal (B) view.. Eso: esophagus, LA: left atrium
case_images: cureus-0015-00000033408-i01.jpg
case_images: PMC9897699_01_cureus-0015-00000033408-i01.jpg
case_images: FIG1
case_images: Computed tomography angiography of the chest and abdomen showing markedly dilated esophagus (Eso) against the left atrium (LA) in axial view.. Eso: esophagus, LA: left atrium
case_images: cureus-0015-00000033408-i02.jpg
case_images: PMC9897699_01_cureus-0015-00000033408-i02.jpg
case_images: FIG2
case_images: Barium esophagram showing dilated esophagus with narrowing at the gastroesophageal junction, demonstrating the classic "bird's beak appearance."
case_images: cureus-0015-00000033408-i03.jpg
case_images: PMC9897699_01_cureus-0015-00000033408-i03.jpg
case_images: FIG3
case_images: Esophagogastroduodenoscopy showing the esophageal lumen filled with undigested food and debris before (A) and after (B) removal.
case_images: cureus-0015-00000033408-i04.jpg
case_images: PMC9897699_01_cureus-0015-00000033408-i04.jpg
case_images: FIG4
case_images: TTE. Esophagogastroduodenoscopy (EGD) revealed a severely dilated esophagus with large amounts of undigested food and hypertonic LES (Figure 4A). The undigested food was removed, and botulinum toxin was injected at the LES, followed by balloon dilation. No mass, strictures, or signs of external compression were seen (Figure 4B).