Flashcards in 30. Achalasia Deck (11):
failure of relaxation of lower esophageal sphincter ( LES) due to loss of myenteric ( Auerbach ) plexus --> high LES resting pressure and uncoordinated or absent peristalsis
1. progressive dysphagia to solids and LIQUIDS ( vs obstruction - solids only )
2. putrid breath
Bird's beak --> barium swallow shows dilated wsophagus an area of distal stenosis
associated with increased risk of esophageal ca ( both SCC and adeno, but esp SCC
causes of achalasia
2. Chagas disease T.cruzi - kissing bug)
3. extraesophageal malignancy ( mass effect or paraneoplastic)
• Achalasia results from the failure of what process to occur?
Relaxation of the lower esophageal sphincter
• In a man with high lower esophageal sphincter resting pressure/uncoordinated peristalsis, you see innervation loss from which plexus?
The myenteric (Auerbach) plexus, which innervates the LES
• What is the most common presenting symptom of achalasia?
Progressive dysphagia to both solids and liquids (vs. obstruction, which presents as dysphagia to solids only)
• After you diagnose a man with achalasia, you should advise him that he has increased risk for what malignancy?
Esophageal squamous cell carcinoma
• A man is diagnosed with new achalasia. He recently traveled to South America. What parasitic disease did he likely contract while there?
Chagas disease (associated with secondary achalasia)