Wide-mouthed sacculation of the esophagus: a cause of dysphagia after radiation therapy.

We describe a patient who presented with dysphagia after radiation therapy for Hodgkin's lymphoma secondary to wide-mouthed sacculation of the upper esophagus on barium esophagography, most likely resulting from localized radiation necrosis of the muscular layer of the esophageal wall. Despite its rarity, radiologists should be aware of this finding as a potential cause of dysphagia after radiation therapy to the neck or chest. Unlike radiation strictures, radiation-induced sacculation of the esophagus probably can be managed conservatively without need for endoscopic dilatation procedures.