Match each classic esophageal disorder with its most characteristic clinical or diagnostic finding.
- AchalasiaIncomplete relaxation of the lower esophageal sphincter and absent peristalsis
- Boerhaave syndromeTransmural rupture of the distal esophagus, often presenting with subcutaneous emphysema
- Mallory-Weiss syndromeLongitudinal mucosal lacerations at the gastroesophageal junction typically presenting with hematemesis
- Diffuse esophageal spasmUncoordinated, simultaneous contractions of the esophagus causing a 'corkscrew' appearance on imaging
Answer
Achalasia matches with incomplete lower esophageal sphincter relaxation. Boerhaave syndrome matches with transmural esophageal rupture. Mallory-Weiss syndrome matches with longitudinal mucosal lacerations. Diffuse esophageal spasm matches with uncoordinated, simultaneous contractions.
Each esophageal disorder has a distinct, classic presentation. Achalasia involves the loss of myenteric plexus neurons leading to lower esophageal sphincter dysfunction. Boerhaave syndrome is a full transmural perforation that leaks contents into the mediastinum, requiring emergent intervention. Mallory-Weiss syndrome is a superficial mucosal tear at the gastroesophageal junction that causes bleeding but does not perforate the esophagus. Diffuse esophageal spasm involves uncoordinated smooth muscle contractions without lower esophageal sphincter dysfunction.
Step-by-Step Solution
Key Concept
Classic presentations and pathophysiology of esophageal disorders