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1671. The New Chicago Classification of Achalasia: How Does It Correlate with the Barium Swallow?
Authors * Denotes Presenting Author
  1. Teal Clocksin *; University of New Mexico
  2. Samuel Martinez; University of New Mexico
  3. Tabitha Kirkendall; University of New Mexico
  4. Archana Kaza; University of New Mexico
  5. William Thompson; University of New Mexico
Objective:
To compare the manometric and barium swallow findings in patients with Type I, II and III Achalasia.

Materials and Methods:
A search of our hospital data base for patients with achalasia was made from 1/1/2013 to 12/29/2018. Patients who had both manometry and a barium swallow within a month were selected. Each patient's medical record was reviewed and both their clinical data and manometry results were recorded. An experienced gastrointestinal radiologist reviewed the radiology reports and images from barium swallows to determine the dysmotility findings. The findings on the barium swallows were correlated with the findings on manometry.

Results:
Fifty-seven patients were found to have the diagnosis of Achalasia in their medical record. Twenty-six were excluded as they did not have a barium swallow. Two additional patients were excluded, one age 12 and the other with no abnormality found on either study. Manometry and barium swallows were compared in the remaining 29 patients. There were 14 males and 15 females with an age range from 25-84 years. Based upon the new Chicago Classification there were 5 patients with Achalasia Type I, 12 with Achalasia Type II , 7 with Achalasia Type III and 6 with miscellaneous manometric abnormalities. Barium Swallow correlation with manometry results: Achalasia Type I 5/5, Achalasia Type II 5/12, Achalasia Type III 3/7 and Miscellaneous 1/5. The barium swallows only correlated with 14 of the 29 manometric studies. It did recoginze all 5 Achalasia Type I patients. Sensitivity snd Specificity of the Ba Sw 67% and 54%,

Conclusion:
The barium swallow classified less than half of our 29 patients with the three types of Achalasia and miscellaneous manometric abnormalities. The barium swallow did identify all the patients with Type I Achalasia. Further research is needed to identify why there is an overlap of findings on the barium swallow in patients with Achalasia Types II and III. Radiologists need to be familiar with the new Chicago Classification of Achalasia based on the new high resolution manometeric findings. They also need to be familiar with the different radiologic findings of the three types of Achalasia demonstrated on the barium swallow.