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12544 Medicine

A 60-year old male pressents with progressivp difficulty in swallowing, vomiting and ocLsional regurgitation for the past 3 months. Barium studies showed marked dilatation of the upper esophagus with narrowmg of the lower segment. Manometry showed absent esophageal peristalsis. The pathogenesis of this condition is most likely related to-

AReflux of gastric acid into the lower esophagus
BAbnormal dilatation of lower esophageal vein
CIncompetence of the lower esophageal sphincter
DAbsence of ganglion cells in the myenteric plexus of the esophagus (Correct Answer)