title: Radiological findings in megaesophagus secondary to Chagas disease: chest X-ray and esophagogram.
abstract: OBJECTIVE
  To identify and classify the radiographic patterns of megaesophagus in Chagas disease, as seen on esophagograms and chest X-rays.
  
  
  METHODS
  This was a prospective study of 35 patients diagnosed with esophageal disease via manometry. The changes found on esophagograms were stratified according to Rezende's classification, divided into four categories (grades I through IV) determined by the degree of dilatation and impairement of esophageal motility. We subsequently correlated that ranking with the chest X-ray findings: gastric air bubble; air-fluid level; and mediastinal widening.
  
  
  RESULTS
  Among the 35 patients, the esophageal disease was classified as grade I in 9 (25.7%), grade II in 3 (8.6%), grade III in 19 (54.3%), and grade IV in 4 (11.4%). None of the patients with grade I esophageal disease showed changes on chest X-rays. In two of the three patients with grade II disease, there was no gastric air-bubble, although there were no other findings in any of the grade II patients. Of the 19 patients with grade III disease, 15 had abnormal findings on X-rays. All four patients with grade IV disease showed abnormalities.
  
  
  CONCLUSIONS
  The use of Rezende's classification is feasible, encompassing findings ranging from the subtle changes that characterize the initial phases of esophageal disease to the complete akinesia seen in dolicomegaesophagus. Chest X-ray findings are more common in patients with advanced stages of the disease and indicate the degree of esophageal involvement in Chagas disease.
authors.affiliation: MsC, Doctoral Student in the Department of Diagnostic Imaging of the Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), Interventional Radiologist at the Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Thiago Giansante
authors.initials: TG
authors.lastname: Abud
authors.affiliation: MD, Radiologist at Documenta - Hospital São Francisco, Doctoral Student in the Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.
authors.forename: Lucas Giansante
authors.initials: LG
authors.lastname: Abud
authors.affiliation: PhD, Radiologist at Documenta - Hospital São Francisco, Ribeirão Preto, SP, Brazil.
authors.forename: Vanessa Sales
authors.initials: VS
authors.lastname: Vilar
authors.affiliation: PhD, Interventional Radiologist, Department of Diagnostic Imaging of the Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil.
authors.forename: Denis
authors.initials: D
authors.lastname: Szejnfeld
authors.affiliation: PhD, Radiologist, Department of Diagnostic Imaging of the Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil.
authors.forename: Samuel
authors.initials: S
authors.lastname: Reibscheid
keywords: Esophageal achalasia/radiography; Esophagus/radiography; Radiography, thoracic