Sticking of Food (Differential Diagnosis)

Esophagography in a 9.4-year-old boy with stuck food in the esophagus prior to (picture on the left) and 7 months after Heller's operation (picture on the right). There is a severe dilatation of the distal esophagus with a conical transition zone leading to a very small and nearly unrecognizable abdominal part of the esophagus. Following surgery there was a normalization of the lumen of both parts of the esophagus. The diagnosis is an achalasia (cardiospasm) of the distal esophagus leading to dyphagia and regurgitation; in Heller's operation a broad strip of muscle of the distal esophagus was excised similar to the myectomy of the internal sphincteric muscle in ultrashort Hirschsprung's disease or in sphincteric achalasia.