drdg
Forum Senior
Topics: 31
Posts: 176
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a 45-year-old male presents to the office with complaints of progressive difficulty in swallowing both solids and liquids. His other complaints include occasional regurgitation of undigested food, and a nighttime cough with disturbs his sleep. The physical exam is unremarkable. Barium studies show a dilated esophagus, loss of esophageal peristalsis, and smooth taering of the distal esophagus. Which of the following is the most appropriate next step in management?
A. Esophagoscopy
B. Esophageal manometry
C. Esophageal Ph Monitoring
D. Botulinum toxin ingestion
E. Pneumatic dilation.
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| drdg
Forum Senior
Topics: 31
Posts: 176
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sorry, and smooth tapering of the distal esophagus
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| hanialkhadher
Forum Elite
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Posts: 256
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A. Esophagoscopy
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| hopefor
Forum Junior
Topics: 10
Posts: 43
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E??????
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| titly
Forum Elite
Topics: 18
Posts: 293
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esophageal manometry
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we spend our days waiting for the ideal path to appear in front of us, but, what we forget is paths are made by walking, not by waiting. keep walking................................
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| Kamsi
Forum Guru
Topics: 103
Posts: 347
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A
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| hgheith
Forum Elite
Topics: 39
Posts: 268
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I believe it's A
then to confirm the diagnosis manometry right?
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| drdg
Forum Senior
Topics: 31
Posts: 176
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Yes, the correct answer is A.
This patient may have achalasis. The initial step is barium studies followed by esophagoscopy to rule out other causes for dysphagia. Manometry is used thereafter for confirming.
Good job everyone.
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