ACHALASIA CARDIA
ACHALASIA CARDIA It is a failure of smooth muscle fibers to relax, which can cause the lower esophageal sphincter(LES) to remain closed. It is esophageal motility disorder. pathology - selective absence of inhibitory neurons and there is absence of LES relaxations. only Auerbach plexus is present and Meisner's plexus is absent. clinical features: most common symptom - Dysphagia > weight loss (dysphagia is more to liquids than solid) Risk of Aspiration - Pneumonitis, that leads to lung abscess increase risk of squamous cell carcinoma (scc) IOC - Barium swallow - BIRD BEAK / RAT TAIL / PENCIL TIP APPEARANCE TREATMENT : TOC - Laproscopic Heller's cardiomyotomy - partial fundoplication - DOR / TOUPET fundoplication done - POEM - per oral endoscopic myotomy