Six cases of diffuse muscular hypertrophy of the esophagus are reported. The clinical diagnosis is often missed and may be confused with achalasia. Some clinical features that help distinguish this disease are a sensation of "grasping" any tube or instrument introduced into the esophagus, marked sustained elevation in the baseline pressure in the body of the esophagus over a longer segment, and poor response to forced pneumatic dilatation (in those cases in which achalasia is suspected). An interesting association was the relationship with diabetes mellitus in four of the six cases described.
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