PMC5703760_01
High-resolution esophageal manometry showing lack of esophageal peristalsis and incomplete lower esophageal sphincter relaxation consistent with type 1 achalasia. Image shows a mean of 11 swallows.
CG-CGCR170083F001.jpg
PMC5703760_01_CG-CGCR170083F001.jpg
F1
Diagnostic manometry revealed aperistalsis of the esophageal body with elevated LES pressure consistent with type I achalasia (Figure 1).
(A) Coronal and (B) sagittal abdominal computed tomography (CT) showing subdiaphragmatic collection (arrows).
CG-CGCR170083F002.jpg
PMC5703760_01_CG-CGCR170083F002.jpg
F2
In the emergency department, she was found to have a white blood cell count of 30.7 K/muL, and a computed tomography (CT) scan of the abdomen revealed a 5.8 cm x 6.9 cm x 2.3 cm fluid collection (Figure 2) near the diaphragm suspicious for an abscess.
Sagittal abdominal CT showing interval improvement in collection (arrow).
CG-CGCR170083F003.jpg
PMC5703760_01_CG-CGCR170083F003.jpg
F3
Her leukocytosis subsequently improved, and a repeat abdominal CT revealed interval decrease in abscess size (Figure 3).