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

Elective esophagogastrectomy and reconstruction by esophagogastrostomy were performed on 55 patients with malignant tumors of the midesophagus, despite invasion of contiguous structures in 60% and regional lymph node involvement in 75%. The operations were invariably palliative. Two patients died within thirty days of operation. Dysphagia was relieved and oral alimentation resumed in the other 53. Twenty-nine patients who had experienced painful swallowing and 16 who had vomiting obtained relief. Survival curves show no improvement from previous decades for patients with malignancies of the middle third of the esophagus. The mean survival was 10.4 months. Mean survival of patients with liver metastases was 3.5 months.
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PMID:Esophagogastrectomy for carcinoma of the middle third of the esophagus. 9 20

Between January 1, 1970, and March 1, 1979, 153 patients with carcinoma of the esophagus or cardia were seen at the Lahey Clinic; 124 (81%) underwent surgical exploration and 102 (82.3%) were found amendable to resection. This report concerns the 82 patients operated on by the senior author, 72 of whom (87.8%) had surgical resection. A variety of resective techniques were used but currently esophagogastrectomy and esophagogastrostomy is preferred, a left thoracotomy being used for low lying lesions; upper thoracic and cervical lesions are approached through a combined abdominal and right thoracic approach or esophagectomy with cervical esophagogastrostomy and without thoracotomy is used. Two deaths occurred within 30 days of operation, a hospital mortality rate of 2.8%. Significant complications developed in 11 patients (15.3%). The average survival was 20.8 months, and satisfactory long-term relief of dysphagia was achieved in 91.2% of patients. An aggressive surgical approach to the management of patients with carcinoma of the esophagus or cardia is justified, for esophagogastrectomy and esophagogastrostomy is applicable to the majority of patients; can now be performed at low risk with a reasonable period of hospitalization; and provides satisfactory long-term palliation.
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PMID:Esophagogastrectomy for carcinoma: current hospital mortality and morbidity rates. 9 17

During the past four years three patients have been seen with ischemia of the colon segment following colon interposition. Colon interposition was done for esophageal cancer in two patients and for esophageal stricture following ingestion of lye. Colon ischemia was manifested as early as two weeks in one patient and as late as eight weeks in the others. Colon ischemia presented a frank gangrene with cervical fistula or as dysphagia due to stricture formation. Dysphagia in two patients prompted mechanical dilatation of the colon segment which led to perforation in both cases. All three patients had empyemas. The management of these patients includes proper diagnosis, drainage of abscesses and antibiotic treatment, hyperalimentation and visceral arteriography to delineate the residual colon for reinterposition. Two of the three patients in the series are long-term survivors and are well.
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PMID:Management of colon ischemia following colon interposition for esophageal substitution. 9 13

The serious prognostic implications of familial dysautonomia (FD) for the affected individual and his family make early definitive diagnosis mandatory. Familial dysautonomia has rarely been diagnosed in the neonatal period in hitherto unaffected families. We describe here three such newborn patients to reinforce the limited data available on this subject. In spite of the variability of expression and the incompleteness of the manifestations of FD in the neonatal period, as well as the presence of a number of "dysautonomic" features in normal newborns, we believe that it is possible to establish a diagnosis of FD neonatally. We pay particular note to the altered state of consciousness and behavior in neonatal FD, the unusual posture and limb movements, and the swallowing disorder with tendency to neonatal aspiration. In addition, the incidental finding of bile pigment in the amniotic fluid of an affected fetus without hemolytic disease may hint at a possible approach to fetal diagnosis of this condition.
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PMID:Neonatal diagnosis of familial dysautonomia. 10 61

Amyotrophic lateral sclerosis is a progressive dengenerative neuromuscular disease of insidious onset. It involves upper and lower motor neurons and causes both spastic and atrophic muscular symptoms. More than one fourth of patients have complaints relating to the head and neck (bulbar palsy); thus, the otolaryngologist may be the first physician to see them. Predominant symptoms are slurred speech, hoarseness, dysphagia, and dyspnea. Muscular weakness, atrophy, and fasciculation are noted on examination. The course is relentless, and only 20% of patients survive five years after diagnosis.
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PMID:The otolaryngologic presentation of amyotrophic lateral sclerosis. 11 40

Rabies is a rare, fatal viral infection, usually transmitted by the bite of an infected animal. Some 30,000 Americans are immunized annually, however, so public health considerations are common. The development of a new vaccine, grown in human diploid cell culture, is discussed. It appears to have high antigenicity with no serious morbidity. A case of a patient with fatal rabies who had fever, delirium, dysphagia, and cervical and pectoral subcutaneous emphysema is presented.
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PMID:Rabies: otolaryngologic manifestations. 11 41

Hypopharyngeal diverticulum and dysphagia due to cricopharyngeus muscle dysfunction are a continuing challenge to the head and neck surgeon. The ability to completely transect the cricopharyngeus muscle is generally agreed to be the key to successful relief of symptoms, and--to an even greater extent--to prevention of recurrence. In the past, the most significant complications arising from such surgery have been recurrent laryngeal nerve injury and recurrent diverticulum or cricopharyngeus spasm. Both of these problems have been prevented by a modified surgical approach which takes advantage of the relatively bloodless retropharyngeal space. The logic of this posterior approach to the cricopharyngeus, from an anatomic standpoint, coupled with the good visualization and relatively bloodless field when approaching the muscle, suggests that it might be a suitable substitute for the more common lateral approach if continued long-term experience in larger number of cases does not lead to significant complications.
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PMID:Hypopharyngeal diverticulum and the cricopharyngeus muscle: a posterior surgical approach. 11 1

Dysphagia is the leading symptom in the most frequent and surgically most important disturbances of the passage of the oesophagus. Possibilities and results of the treatment are analysed on the basis of clinical material from the surgical clinic of Halle university. Nevertheless insufficient results in malignant tumours are opposite to favourable results of the operation in benign diseases (diverticles, achalasia, strictures). Measures for the improvement of the situation of treatment are discussed.
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PMID:[The value of the symptom of dysphagia from the surgeon's viewpoint]. 11 48

Cricopharyngeal dysfunction, one of the most common causes of pharyngeal dysphagia, exhibits a variety of manifestations, one of which is Zenker diverticulum. This paper examines the physiology of swallowing, pathophysiology of its aberrations, and various methods of treating Zenker diverticulum. It is our purpose to emphasize cricopharyngeus (CP) myotomy as the only needed treatment for this diverticulum. Even in its advanced stages, excision of the diverticulum is a needless surgical exercise. Seven cases of Zenker diverticulum are reported in elderly patients; one of them had an excision of the diverticulum prior to presentation. Some were either completely obstructed or aspirating on esophagram. Cricopharyngeus myotomy, the only treatment provided, proved to be safe and effective without morbidity or fatalities. Patients' ability to eat orally was restored on the night of or the morning after surgery. No Levin tube is necessary and there is no risk of suture line leakage after the conventional diverticulectomy and CP myotomy. Hospital stay is greatly reduced and there is no risk of structure formation. In contrast to endoscopic division of CP muscle, there is no risk of mediastinitis because there is no break through the mucosa.
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PMID:Cricopharyngeus myotomy as the only treatment for Zenker diverticulum. 11 33

Dysphagia is a symptom of organically or functionally conditioned diseases of the oesophagus. In all circumstances it demands an immediate clarification of the etiology considering appropriate therapeutical measures and above all may be first reference to the carcinoma of the oesophagus.
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PMID:[Dysphagia, diagnostic and therapeutic measures]. 12 85


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