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Walter Chan, MD, MPH, FACG Profile picture
Walter Chan, MD, MPH, FACG
@WalterChanMD
Director, GI Motility @BrighamGI @BrighamWomens / Assistant Professor of Medicine @HarvardMed / @WUSTL, @WashUSwim, @WUSTLmed, @WashUIMRes, @HarvardHSPH alum
Jul 11, 2020 • 4 tweets • 2 min read
Discussion from this past #TracingTuesday:

As many have noted, this tracing showed inadequate LES relaxation & no normal esophageal body peristalsis - the definition for #achalasia. There’s evidence of esophageal shortening in some swallows, causing pseudo-relaxation. (1/4) This study does not clearly fall into any of 3 achalasia subtypes: no failed swallow, no PEP >30 mmHg, no spastic contractions (DL >4.5). Note the difference b/t true PEP (non-contractile, uniform pressurization) and this case, which has a clear distal contraction fragment. (2/4)