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git - sjsmmd
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03-06-2010, 05:00 PM
A 60 year old man presents with a 4 month history of dysphagia and weight loss. A diagnosis of achalasia is made. Which of the following is the best way to provide symptomatic relief?
A. Surgical cardiomyotomy B. Propanolol C. Isosorbide mononitrate D. Gaviscon E. Magnesium trisilicate
03-06-2010, 05:18 PM
best way to provide symptomatic relief= Surgical cardiomyotomy?
03-06-2010, 06:04 PM
Answer: a) Surgical cardiomyotomy. Cardiomyotomy entails surgical division of the lower oesophageal sphincter. Mortality rates of less than 1% and success rates of over 85% have been recorded. There is however a high incidence (up to 10%) of oesophageal reflux post-operatively progressing in a number of cases to peptic stricture. For achalasia, nitrates and hydralazine can help in short term.
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