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Surgery Stomach & Duodenum 9efe777e

A 50-year-old gynecologist complains of dysphagia, regurgitation, and weight loss. She also states that she feels as if food is stuck at the level of the xiphoid. An upright chest x-ray shows a dilated esophagus with an air-fluid level. Which of the following is FALSE?

A
A barium swallow will show a "bird's beak" deformity
B
Manometry will demonstrate that the LES fails to relax during swallowing.
C
Upper endoscopy should be avoided because of the risk of complications.
D
Medical treatment includes nitrates and calcium channel blockers.
High-Yield Explanation
The symptoms and radiologic findings in this patient suggest achalasia. Evaluation includes endoscopy to rule out a stricture or cancer. Barium swallow will show a dilated esophagus, failure of the LES to relax during swallowing, and a lack of peristalsis. Nonoperative management is of limited usefulness but may be considered in high-risk patients who are not candidates for surgery.

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