Gastrointestinal surgery: diffuse oesophageal spasm: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Gastrointestinal surgery: diffuse oesophageal spasm

Sample item

A 45-year-old has intermittent chest pain and dysphagia for both solids and liquids. Barium swallow shows a corkscrew oesophagus, and manometry shows simultaneous contractions with normal lower oesophageal sphincter relaxation. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Diffuse oesophageal spasm

Diffuse oesophageal spasm is a motility disorder with premature or simultaneous contractions that cause a corkscrew or rosary-bead barium appearance and chest pain mimicking angina. Lower sphincter relaxation is normal, which separates it from achalasia. Treatment includes calcium channel blockers or nitrates, and myotomy for refractory cases.

Option by option

  • A. Systemic sclerosis of the oesophagus

    Systemic sclerosis gives a hypotensive sphincter and absent peristalsis with reflux, not simultaneous contractions.

  • B. Peptic oesophageal stricture

    A peptic stricture gives progressive dysphagia to solids with long-standing reflux and a smooth narrowing.

  • C. Achalasia cardia

    Achalasia has absent peristalsis and incomplete lower sphincter relaxation, with a bird's beak appearance.

  • D. Diffuse oesophageal spasm (correct)

    Correct. Simultaneous contractions with intact sphincter relaxation define diffuse oesophageal spasm.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Diffuse oesophageal spasm. Diffuse oesophageal spasm is a motility disorder with premature or simultaneous contractions that cause a corkscrew or rosary-bead barium appearance and chest pain mimicking angina.

Why is "Systemic sclerosis of the oesophagus" not the answer?

Systemic sclerosis gives a hypotensive sphincter and absent peristalsis with reflux, not simultaneous contractions.

Why is "Peptic oesophageal stricture" not the answer?

A peptic stricture gives progressive dysphagia to solids with long-standing reflux and a smooth narrowing.

Why is "Achalasia cardia" not the answer?

Achalasia has absent peristalsis and incomplete lower sphincter relaxation, with a bird's beak appearance.

What concept does this question test?

It tests Gastrointestinal surgery: diffuse oesophageal spasm in General Surgery. Lower sphincter relaxation is normal, which separates it from achalasia. Treatment includes calcium channel blockers or nitrates, and myotomy for refractory cases.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastrointestinal surgery: diffuse oesophageal spasm?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.