A lady presented with non progressive dysphagia only for solids. Barium study showed proximal esophageal dilatation with distal constriction. The most likely diagnosis is:
Lady in the question with non progressive dysphagia only for solids, and barium study showing proximal esophageal dilatation with distal constriction is suffering from lower esophageal ring. Esopageal schatzki ringsare smooth, circumferential, thin mucosal structures located in the distal esophagus at the squamo columnar junction. Solid food dysphagia occur with rings less than 13mm in diameter. Dysphagia is intermittent and non progressive. Barium swallow shows proximal esophageal dilatation with distal constriction. Symptomatic patients with a single ring can be treated with the passage of large >16mm diameter bougie dilator to disrupt the lesion, or endoscopic electrosurgical incision of the ring is done. Ref: Current medical diagnosis and treatment 2012, Chapter 15, 39'; Harrisons internal medicine 18th edition, Chapter 292.
Peptic Stricture
Carcinoma Esophagus
Achalasia Cardia
Lower Esophageal Ring