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Medicine General 1a4e91a4

A 30 year old female patient presents with non progressive dysphagia, for both solids and liquids. The charachteristic finding on baruim swallow that will confirm the probable diagnosis is:

A
Dilated esophagus with narrow lower end (Rat tail esophagus)
B
Multiple sacculations and pseudodiveiculae (Corkscrew esophagus)
C
Narrow and irregular esophageal lumen
D
Stricture ulcer in the esophagus
High-Yield Explanation
Answer is B (Multiple sacculations and pseudodiveiculae Corkscrew esophagus) Current Diagnosis and Treatment in Gastroenterology The presence of non progressive dysphagia to both solids and liquids suggests the diagnosis of diffuse esophageal spasm. The charachteristic barium swallow findings in diffuse esophageal spasm is the corkscrew esophagus (appearance of curling or multiple ripples in the wall, sacculations and pseudodiveicula) Rat tail esophagus with a dilated proximal esophagus and narrow lower end suggests a diagnosis of Achlasia cardia. (Dhingra 4th/305) Achlasia is associated with Progressive dysphagia to both solids and liquids Narrow and irregular esophageal lumen suggests a diagnosis of esophageal carcinoma (Dhingra 4th/306) Esophageal carcinomas are associated with progressive dysphagia. Which is initially only for solids at presentation (may prgress to cause dysphagia to liquids also) Stricture or ulcer in the esophagus suggests a diagnosis of Gastrophageal Reflux disease (GERD) (H 16th/1743) GERD is asociated with progressive dysphagia to solids alone at presentation.

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