A 41-year-old woman presents with several months of progressive dysphagia to both solids and liquids. She also reports regurgitation of undigested food and a 4-kg weight loss. Physical examination is unremarkable. A barium swallow shows a dilated esophagus with smooth tapering at the distal end. Which of the following best explains the pathogenesis of this disorder?
- A)Metaplastic transformation of distal squamous epithelium into columnar epithelium
- B)Hypertrophy of the pyloric circular muscle
- C)Autoimmune destruction of parietal cells with loss of intrinsic factor
- D)Longitudinal mucosal lacerations at the gastroesophageal junction
- E)Loss of myenteric inhibitory neurons containing nitric oxide and vasoactive intestinal peptideGABARITO
Explicação
Achalasia is caused by degeneration of inhibitory neurons in the myenteric plexus, leading to impaired lower esophageal sphincter relaxation and loss of esophageal peristalsis. Dysphagia to solids and liquids together with the bird beak appearance on barium sw... Ver explicação completa e trilha adaptativa →