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Achalasia — ESEGH MCQ

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HardLuminal GIAchalasiaESEGH

Manometry shows elevated IRP and absent peristalsis, with panesophageal pressurisation in 60% of swallows and no premature contraction. Which subtype is present?

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Correct answer: E — Type II achalasia with panesophageal pressurisation

Explanation lettering: C = shown as A · A = shown as C · E = shown as D · D = shown as E

D is correct. Elevated IRP, absent peristalsis and panesophageal pressurisation in at least 20% defines type II. A lacks pressurisation; B requires premature contractions; C retains peristalsis; E requires normal EGJ relaxation and premature contractions.

Reference: Chicago Classification v4.0 clinical impact: https://pmc.ncbi.nlm.nih.gov/articles/PMC9021169/