Question 1774
{"accessible":true,"alternatives":[{"id":8810,"text":"achalasia"},{"id":8811,"text":"Chagas disease"},{"id":8812,"text":"malignant oeasophageal stricture"},{"id":8813,"text":"esophageal manifestations of sclerodermia"}],"archived":false,"correctAlternativeId":8810,"explanation":"\u003cp\u003eThere is an esophageal dilatation with stasis,\u0026nbsp;acute tapering at the lower esophageal sphincter (\u003ca href=\"https://radiopaedia.org/articles/bird-beak-sign-oesophagus?lang=gb\"\u003ebird beak sign\u003c/a\u003e), and narrowing at the gastro-esophageal junction.\u0026nbsp;Normal mucosal pattern with no irregularities or ulceration seen.\u0026nbsp;No evidence of hiatus hernia or\u0026nbsp;extrinsic compression is seen.\u003c/p\u003e\u003cp\u003eChagas disease\u0026nbsp;is a tropical parasitic infection, endemic in Central and South America. The gastrointestinal manifestations are seen in\u0026nbsp;10-15% of affected patients and include esophageal dysmotility/megaesophagus,\u0026nbsp;megaduodenum,\u0026nbsp;small bowel dilatation, and\u0026nbsp;megacolon. Other manifestations include: cardiac, genitourinary, and CNS origin.\u003c/p\u003e\u003cp\u003eMalignant esophageal strictures usually are characterized by an irregular margin +/-\u0026nbsp;shouldering, and\u0026nbsp;pre-stricture dilatation with 'hold up'.\u003c/p\u003e\u003cp\u003eEsophageal manifestations of scleroderma are seen\u0026nbsp;in 80% of cases. In addition to the gastrointestinal manifestations, the\u003ca href=\"/articles/gastro-oesophageal-junction-goj\"\u003e\u0026nbsp;\u003c/a\u003egastro-esophageal junction will be open\u0026nbsp;and the esophageal dilatation is less severe as compared to that of achalasia.\u003c/p\u003e\u003cp\u003e\u0026nbsp;\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u0026nbsp;\u003c/p\u003e\u003cp\u003e\u0026nbsp;\u003c/p\u003e","id":1774,"imageUrl":"https://prod-images-static.radiopaedia.org/multiple_choice_questions/270/achalasia-26_big_gallery.jpeg","imageAttribution":{"kind":"case","rID":61006},"imageAttributionCaseInfo":{"title":"Achalasia","contributor_name":"Mohammad Taghi Niknejad","contributor_param":"dr mt niknejad","case_rid":61006,"case_param":"achalasia-26"},"firstQuestionPath":"/questions/1774","nextQuestionPath":"/articles/scleroderma-gastrointestinal-manifestations-1/questions/1146","relatedArticles":[{"id":19896,"title":"Chagas disease","link":"/articles/chagas-disease?lang=us"},{"id":1767,"title":"Esophageal stricture","link":"/articles/oesophageal-stricture?lang=us"},{"id":20000,"title":"Pseudoachalasia","link":"/articles/pseudoachalasia?lang=us"},{"id":41562,"title":"Esophageal dysmotility","link":"/articles/oesophageal-dysmotility?lang=us"},{"id":1765,"title":"Esophageal carcinoma","link":"/articles/oesophageal-carcinoma-1?lang=us"},{"id":43071,"title":"Megaesophagus","link":"/articles/megaoesophagus-1?lang=us"}],"alsoUsedIn":[],"stem":"\u003cp\u003eA 40-year-old woman with a history of dysphagiia\u0026nbsp;for both solids and liquids. A barium meal was performed. What is the most likely diagnosis shown on this selected image?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/1774"}],"attemptsPercentages":[{"alternativeId":"8811","percentage":3},{"alternativeId":"8810","percentage":80},{"alternativeId":"8812","percentage":10},{"alternativeId":"8813","percentage":7}],"promptToLogin":false,"questionManager":false,"articleId":"scleroderma-gastrointestinal-manifestations"}