Clinical presentation

A 66-year-old man presented with a 20-year history of progressively worsening dysphagia and intermittent chest pain. The patient described a sensation of food ‘sticking’ in his lower chest which occurred with both solids and liquids, impacting his quality of life significantly. His medical history was otherwise unremarkable with no known allergies, prior surgeries or chronic conditions. During the initial evaluation, a barium swallow was performed. The imaging revealed a notable and unusual spiral-shaped alteration in the morphology of the middle to the lower oesophagus (figure 1). This morphological change was accompanied by a mild irregular narrowing of the oesophageal lumen (figure 2). Despite this irregular narrowing, a subsequent endoscopic examination of the oesophagus revealed no signs of mucosal damage or lesions effectively ruling out the presence of oesophageal cancer. Given …