Presentation
3 week history of vomiting and cough after eating or drinking water.
Patient Data
The thoracic esophagus is dilated and gas filled.It is visible on both lateral projections, and superimposed on the heart and spine on the d/v projection.
There is alveolar pulmonary pattern in the left and right cranial lung lobes, and right middle lung lobe. These are seen best on the lateral projections.
Megaesophagus with aspiration pneumonia.
Case Discussion
Antibody tests for acetylcholine receptor were positive for myasthenia gravis.
Aspiration pneumonia is a common complication of megaesophagus. Because the distribution of aspiration pneumonia is ventral, it is often not visible on a v/d or d/v projection as it is superimposed on the heart and mediastinum. Two lateral projections are needed to evaluate the lungs.
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