Match each classic clinical presentation with its most likely esophageal diagnosis.
- A 45-year-old patient with dysphagia to both solids and liquids, regurgitation of undigested food, and a 'bird's beak' appearance on a barium swallow study.Achalasia
- A 60-year-old patient with a long history of untreated gastroesophageal reflux disease who now reports progressive dysphagia initially to solid foods, accompanied by unintentional weight loss.Esophageal adenocarcinoma
- A 35-year-old patient presenting with severe, retrosternal chest pain and subcutaneous emphysema in the neck following multiple episodes of forceful retching.Boerhaave syndrome
- A 40-year-old patient presenting with episodic, severe, non-cardiac chest pain and a 'corkscrew' appearance on a barium swallow study.Diffuse esophageal spasm
Answer
The patient with a 'bird's beak' appearance matches Achalasia. The patient with chronic GERD and progressive dysphagia matches Esophageal adenocarcinoma. The patient with transmural rupture following forceful vomiting matches Boerhaave syndrome. The patient with a 'corkscrew' esophagus matches Diffuse esophageal spasm.
Each clinical vignette provides pathognomonic features for a specific esophageal pathology, allowing direct diagnosis based on classic illness scripts expected for the exam.
Step-by-Step Solution
Key Concept
Classic clinical presentations and radiologic findings of major esophageal disorders.