A 42 year old mechanic has a three month history of progressive dysphagia and marked weight loss

Question Number 0667

Question:
A 42 year old mechanic has a three month history of progressive dysphagia and marked weight loss. He describes a senstation of sticking of both solid food and liquids behind his sternum. He has effortless regurgitation after eating, particularly on bending forward or reclining. This is not associated with a sour taste. A plain chest X-ray demonatrates a high air/fluid level behind the heart. On endoscopy the esophagoscope can easily be passed into the stomach A likely diagnosis is

a) Candida albicans
b) pharyngeal pouch
c) esophageal diverticulum
d) achalasia
e) rolling hiatus hernia


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