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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 12-year old boy had a five-year course of dysphagia secondary to lower esophageal obstruction by a posterior mediastinal extension of an inflammatory pseudotumor of the lung. The case illustrates the capacity of pseudotumor to behave in a locally aggressive manner and to present in extrapulmonic sites.
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PMID:Unusual presentation of pulmonary inflammatory pseudotumor (plasma cell granuloma) as esophageal obstruction. 45 45

The effects of subcutaneous pentagastrin (6 microgram/kg) on esophageal motility were recorded in patients with achalasia, in patients with idiopathic diffuse esophageal spasm (IDES), and in healthy subjects. In achalasia and IDES, pentagastrin produced an increase in mean lower esophageal sphincter pressure, amplitude of contractions, esophageal pressure, and repetitive wave activity. Also, chest pain or dysphagia occurred after pentagastrin administration in 4 of 9 patients with IDES and in 7 of 12 patients with achalasia. After comparing these observations with those of healthy subjects, we tested the potential for pentagastrin-induced motility changes to improve our ability to diagnose IDES. This was done by administering pentagastrin to 22 patients with clinically "suspected" esophageal motor disease but in whom routine radiologic and manometric studies were nondiagnostic. In none of the 22 did symptoms or manometric changes develop to help establish the diagnosis of IDES. This was true despite additional studies in 10 patients that failed to provide an alternative to IDES as the diagnosis. These results do not support the use of pentagastrin as a provocative test for IDES.
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PMID:The effects of pentagastrin in achalasia and diffuse esophageal spasm. 45 41

Esophageal manometric tracings obtained using low-compliance pneumohydraulic infusion systems were reviewed from patients with symptoms of chest pain and/or dysphagia. Using this sytem, we report on 7 symptomatic patients with markedly increased esophageal peristaltic amplitude. Maximal peristaltic amplitude for these 7 patients (225-430 mmHg) was greater than for normals (75-175 mmHg). Mean peristaltic amplitude for the 7 was 170 mmHg, which was greater than for normals (81 +/- 30 mmHg, mean +/- 2 SD). This finding is believed to reflect the sensitivity of currently available manometric systems. It may be possible with these techniques to define more clearly the bulk of presumed esophageal dysfunction, which is at present poorly characterized. The relationship of clinical symptoms to abnormal esophageal motility is often less than optimal and may result from an inability to define "normal" or from inadequacies of currently available techniques. Our observations of a subset of symptomatic patients having peristaltic contractions with amplitudes exceeding the normal range seem to characterize one form of esophageal motility defect. This abnormality was seen more frequently than diffuse esophageal spasm in our laboratory.
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PMID:High amplitude, peristaltic esophageal contractions associated with chest pain and/or dysphagia. 45 42

A 62-year-old man presented with a grand mal seizure, progressive abdominal distention, and refractory hypotension 18 years after colonic bypass of a benign stricture of the low middle third of the esophagus. He died 3 hours after admission to the hospital. The patient had a history of liniment ingestion in childhood plus a long history of dysphagia and substernal pain. Autopsy disclosed a large ulcer of the anterior wall of the distal esophagus, which had eroded through the posterior wall of the left atrium. Histologic examination revealed chronic esophagitis with fibrous obliteration of the esophageal wall, pericardium, and left atrial myocardium near the site of perforation. Foreign material was present within small arteries of multiple viscera, and in several of these fragments transverse striations were demonstrated. Esophageal-atrial perforation is a rare but fatal complication of chronic esophageal ulceration. The clinical and pathological features of this and previously reported cases of nontraumatic esophageal-atrial perforation are reviewed.
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PMID:Esophageal-atrial perforation due to recurrent esophagitis 18 years after esophageal bypass surgery. 45 25

This patient with histologically proved Riedel's thyroiditis had hypothyroidism of sufficient severity to cause panhypopituitarism, and it was this which first brought him to medical attention. The beneficial effects are described of surgery in relieving severe dysphagia and stridor, and of prednisone in softening and shrinking the hard neck mass. The extent of pituitary failure, and the degree of recovery on treatment with thyroxine are reported, together with details of 4 other cases of Riedel's thyroiditis seen by one of the authors (S.T.).
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PMID:Riedel's thyroiditis leading to severe but reversible pituitary failure. 46 Dec 83

The first symptoms of cancer of the oesophagus in 82 Xhosa patients were found to be dysphagia (43%), interscapular back pain (23%), sore throat (21%) and epigastric pain (11%). More than half of the patients in whom a sore throat was the first symptom of the disease described the simultaneous occurrence of oropharyngeal lesions (amaqhakuva). No correlation could be found between the first symptoms and the characteristics of the oesophageal carcinoma at the time of presentation.
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PMID:The first symptoms of carcinoma of the oesophagus, with particular reference to amaqhakuva. A report from the Republic of Transkei. 46 28

Dysphagia, or difficulty swallowing, can interfere with independent feeding in the physically disabled adult. The physiology of normal swallowing and neuromuscular pathology of dysphagia applicable to the occupational therapist are reviewed in this paper. Pertinent nursing care of the respiratory and gastrointestinal tracts are described. Normal and pathological reflexes involved in swallowing include gag, bite, and suck-swallow. Head, neck, and jaw stability are necessary for swallowing. Methods for evaluating the appropriate reflexes, sensation, and orofacial movement of the adult neurologically impaired patient are presented. Proper positioning is described and treatment suggestions are offered and applied to four case studies.
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PMID:Dysphagia: an evaluation and treatment program for the adult. 46 18

A patient is presented with findings of separate intracranial and extracranial meningiomas, each of a different histologic type. A calcified fibrous meningioma, with secondary psammomatous features, presented as a left neck mass associated with hoarseness, dysphagia, a unilateral facial weakness and hearing loss. A noncalcified asymptomatic intracranial syncytial meningioma was discovered in the left frontal lobe after computerized tomographic and angiographic study of the cranial contents. The origin of the extracranial meningioma producing multiple unilateralcranial nerve disturbances and serous otitis media is discussed. The noncontiguous tumors in this patients are felt to have separate origins, with the extracranial lesion most likely arising in the temporal bone.
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PMID:Extracranial meningioma. 46 34

In protracted forms of dysphagia associated with neuromuscular dysfunction, myotomy of the upper esophageal sphincter has been suggested. The literature, however, is unclear about the indications and outcome of this procedure. In this article, 3 cases are presented of dysphagia associated with the failure of relaxation of the cricopharyngeus during swallowing. Two patients had brain stem infarctions and the 3rd had an inflammatory disease of the brain stem. In all patients, barium swallow revealed aspiration of contrast material into the trachea with failure of relaxation of the cricopharyngeal sphincter. Indirect laryngoscopy demonstrated partial paralysis of one or both vocal cords. In one, an emg of the laryngeal muscles showed normal results. A complete evaluation by the speech pathologist failed to reveal abnormality of the oral musculature in all patients. All patients required gastrostomies for their nutritional needs. Therapeutic modification and control of rate, quantity and consistency of food along with counseling for prevention of aspiration. Oral feeding, without aspiration, was achieved in the 3 patients within the treatment period, allowing removal of the gastrostomy. Cricopharyngeal myotomy, therefore, was not necessary in these patients, despite the long duration of the swallowing problem.
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PMID:Dysphagia associated with cricopharyngeal dysfunction. 46 85

Modified Heller's esophagomyotomy for achalasia of the esophagus was done in 145 patients at Henry Ford Hospital, Detroit, from 1951 to 1977. Information on current symptoms was obtained for 121 patients from a detailed questionnaire that was sent to all patients, from personal interviews, or from data obtained from patients' clinical records. Average period of follow-up was 85 months. Actuarial analysis of postoperative symptoms showed an incidence of reflux of 24% after one year and 48% after ten years; incidence of relief of dysphagia was 89% of all patients after one year and 81% after ten years. Continual surveillance of patients after esophagomyotomy must be stressed. Dissatisfaction with the results of this procedure prompted us to recommend that an antireflux operation be performed at the time of the initial procedure.
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PMID:Long-term results of esophagomyotomy for achalasia of esophagus. 46 8


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