The severity of achalasia as seen on barium swallow radiographs can be graded based on the esophageal diameter and its tortuosity.
Maximum Diameter
Shape of Esophagogastric Passage
Grade
< 4 cm
I
4 – 6 cm
II
> 6 cm
not sigmoid shaped
III
sigmoid shaped
IV
where:
• Grade III or IV achalasia may be referred to as megaesophagus.
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Specialty: Gastroenterology
