A 47-year-old female presented with 6 months of dysphagia and difficulty swallowing solid foods, as well as 4 months of odynophagia and weight loss of 2 kg over 6 months. Examinations and investigations including endoscopy, barium swallow, esophageal manometry and CT scan revealed achalasia cardia. The patient underwent balloon dilatation and will follow up every 6 months with barium swallow tests.

1. DR.BANU CHANDER PANDIAN S
MBBS ,DNB FAMILY MEDICINE
( RESIDENT)

2.  47 yrs female came with chief complaints of
 Dysphagia 6 months(more for solid )
 Odynophagia 4 months
 Weigh loss 2 kg over 6 months
 Nocturnal cough
 Regurgitation on/off 4 months

3. Family history
 Maternal uncle died due GI cancer
 Further details unknown

4. General examination
 Concious ,oriented ,afebrile
 No pallor
 No icterus
 No odema
 No lympadenopathy
 No cyanosis

5. Systemic examination
 Respi – B/L air entry present
 Cvs – s1 s2 heard
 P/A - soft ,non tender
 Cns - NFND

6. Provisional diagnosis
?????????????

8. Investigations
 Endoscopy
 Barium swallow
 Eosophageal manometry
 CT scan

9. Barium swallow

10. Endoscopy

13. CT scan

15. Final diagnosis
Achalasia cardia

16. Treatment
 Medical
calcium channel blocker
 Botulinium toxin
 Ballon dilatation
 Surgical
heller myomectomy

17. Baloon dilatation

23. Follow up
 Every 6 months with barium swallow