Presentation
Presents for 1 week history of wheezing, drooling, and retching.
Patient Data
The pharynx and nasopharynx are dilated on all projections. There is mild increased soft tissue opacity of the larynx.
The intrathoracic esophagus is diffusely distended, containing fluid. The cardiopulmonary structures appear to be within normal limits. Within the viewable abdomen, a large volume of gas is present within the GI tract. There is marked osteophytosis of the elbows bilaterally.
Case Discussion
Megaesophagus.Upper airway obstruction causing laryngeal dilation.
Differential diagnoses for megaesophagus included neurogenic causes (myasthenia gravis, dysautonomia), mass effect at lower esophageal sphincter due to neoplasia, stricture due to chronic esophagitis, toxin (lead toxicosis). Further workup was not pursued.
The larynx was poorly functioning on oral examination with edematous tissue. A cause was not identified, but neuropathy associated with the megaesophagus was considered possible (myasthenia gravis).
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