A 32-year-old woman presented with difficulty in swallowing for 1 year. The dysphagia was progressive and was predominant for solid foods. There was no nasal regurgitation, choking or coughing during swallowing. Her appetite and weight was preserved. She complained of easy fatigability and tiredness at work for the last 6 months.

General examination revealed anaemia with glossitis, angular cheilitis and flattening of the finger and toe nails.

Barium swallow was done and is shown in Figure 1.

Author information: Pazhanivel Mohan, Senior Registrar; Jayanthi Venkataraman, Professor of Gastroenterology; Department of Gastroenterology, Stanley Medical College, Royapuram, Chennai, India

Correspondence: Pazhanivel Mohan, MD, Department of Gastroenterology, Stanley Medical College, Old Jail Road, Royapuram, Chennai – 600001, India. Email: dr.pazhani@gmail.com