American trypanosomiasis (Chaga's disease) may result in megaesophagus. Rezende developed a staging system for megaesophagus based on anatomic and radiologic features.
Esophageal Diameter
Gross Anatomy
Barium Swallow Study
Stage
normal
normal
no retention
0
normal
tertiary contractions present
small barium retention in lower esophagus
I
mild to moderate dilatation
greater number of tertiary contractions
barium retention into mid-third of the esophagus
II
moderate to severe dilatation
normal longitudinal axis maintained
significant barium retention
III
severe dilatation
longitudinal axis deviated
IV
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