Features of achalsia cardia are all of the following except: March 2009
Correct Answer: Rat-tail deformity and filling defect on barium study
Description: Ans. C: Rat-tail deformity and filling defect on barium study Dysphagia is the most common presenting symptom in patients with achalasia. The ingestion of either solids or liquids can result in dysphagia. Emotional stress and the ingestion of cold liquids are well-known exacerbating or precipitating factors. 80-90% of patients with achalasia experience spontaneous regurgitation of undigested food from the esophagus during the course of the disease. Features of achalasia depicted at barium study under fluoroscopic guidance include the following: Failure of peristalsis to clear the esophagus of barium with the patient in the recumbent position Antegrade and retrograde motion of barium in the esophagus secondary to uncoordinated, nonpropulsive, teiary contractions Pooling or stasis of barium in the esophagus when the esophagus has become atonic or noncontractile (which occurs late in the course of disease) LES relaxation that is incomplete and not coordinated with esophageal contraction Dilation of the esophageal body, which is typically maximal in the distal esophagus Tapering of the barium column at the unrelaxed LES, resulting in the bird beak sign
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