Match each esophageal motility disorder with its characteristic finding on high-resolution esophageal manometry.
- AchalasiaAbsent distal esophageal peristalsis and incomplete lower esophageal sphincter (LES) relaxation
- Diffuse esophageal spasmPremature, simultaneous, non-peristaltic distal esophageal contractions with normal LES relaxation
- Systemic sclerosis (scleroderma)Absent peristalsis in the distal two-thirds of the esophagus and decreased LES resting pressure
- Hypercontractile (Jackhammer) esophagusExtremely high-amplitude, prolonged peristaltic contractions with normal LES relaxation
Answer
Achalasia matches with absent distal peristalsis and incomplete LES relaxation. Diffuse esophageal spasm matches with premature, simultaneous contractions and normal LES relaxation. Systemic sclerosis matches with absent peristalsis and decreased LES resting pressure. Hypercontractile esophagus matches with extremely high-amplitude peristaltic contractions and normal LES relaxation.
Each matching pair accurately reflects the underlying pathophysiology of the respective esophageal motility disorder as demonstrated on high-resolution manometry. The LES resting pressure and relaxation, along with the presence, amplitude, and coordination of distal peristalsis, provide the diagnostic hallmarks for each condition.
Step-by-Step Solution
Key Concept
Esophageal motility disorders have distinct manometric signatures based on their effect on the lower esophageal sphincter and distal smooth muscle.