NUTCRACKER ESOPHAGUS

1. CHIEF COMPLAINT •Nutcracker esophagus 2. HPI 3. ROS 4. SYMPTOMS •Chest pain •Dysphagia •Difficulty swallowing •Heartburn 5. HISTORY •FAMILY HISTORY o Diabetes •SOCIAL HISTORY •PASTMEDICAL HISTORY •SURGICAL HISTORY •CHRONIC CONDITIONS 6. ALLERGIES 7. PHYSICAL EXAMINATION 8. SPECIFIC DATA LIKE GRADING ETC 9. TESTS TO BE ORDERED •Barium swallow •Esophageal manometry •Blood sugar •Hemoglobin A1C •CT scan •Catheter-based high-frequency intraluminal ultrasound •Esophageal pH recording •Endoscopy 10.ASSESSMENT /PLAN Surgical Care •Myotomy

•Esophagectomy 11.EDUCATION 12.MEDICATION •Diltiazem •Isosorbide dinitrate •Sildenafil •Trazodone •Imipramine •Botulinum toxin 13.FOLLOW-UP

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