Snapshot A 41-year-old man presents to the clinic complaning of substernal chest pain and regurgitation of undigested food. He also reports having difficulty swallowing both solid and liquids. A barium esophgram demonstrates a dilated proximal esophagus with a narrow tapering. Introduction Motor disorder of the distal esophagus secondary to progressive degeneration of the Aurbach plexus (ganglion cells in the myenteric plexus) Epidemiology login to view 7 more bullets Etiology login to view 4 more bullets Pathogenesis login to view 5 more bullets Prognosis login to view 1 more bullet Presentation Symptoms login to view 6 more bullets Imaging Radiography login to view 1 more bullet Barium esophagram login to view 2 more bullets Upper endoscopy login to view 3 more bullets Esophageal manometry login to view 3 more bullets Differential Gastroesophageal reflux disease (GERD) login to view 3 more bullets Pseudoachalasia due to malignancy login to view 2 more bullets Cardiovascular dysphagia login to view 3 more bullets Treatment Medical management login to view 5 more bullets Operative login to view 9 more bullets Complications Esophageal carcinoma login to view 1 more bullet ulceration and bleeding