Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Foreign body ingestion is a common occurrence in children and in specific high-risk groups of adults such as those with underlying esophageal disease, prisoners, the mentally retarded, and those with psychiatric illnesses. Although most foreign bodies pass through the gastrointestinal tract without difficulty, sharp, pointed, and elongated foreign bodies are associated with a greater risk of perforation, vascular penetration, and other complications. Foreign body ingestion is usually diagnosed based on a history of ingestion given by the patient or an observer. However, children and impaired adults may be unable to give an accurate history, and a high index of suspicion must be maintained in these groups. Dysphagia and odynophagia are the usual symptoms of foreign body impaction in the esophagus. Respiratory symptoms due to compression of the adjacent trachea are also common in younger children and are occasionally the presenting symptom in adults. The preferred method of removal of esophageal foreign bodies is extraction with the flexible endoscope. This may be accomplished in both adults and children with the use of conscious sedation rather than general anesthesia. The availability of grasping instruments specifically designed for foreign body removal and snares greatly facilitates endoscopic extraction. An overtube conveys all of the advantages of the rigid esophagoscope to the flexible endoscope, enabling extraction of sharp and pointed foreign bodies while protecting the mucosa from injury. Adherence to the general principles of foreign body removal and proper preparation result in successful removal rates as high as 98%, with minimal or no complications. Nonendoscopic methods of removal are associated with increased risks of perforation and aspiration and generally should be avoided, with the exception of a trial of intravenous glucagon. Surgical removal is rarely indicated except in the event of perforation or other foreign body complications.
 ...
PMID:Esophageal foreign bodies. 178 10

A 67-year-old woman was admitted on June 21, 1990 because of an abnormality on chest roentgenogram, a three-month history of palpitations on exertion, and a 2 kg weight loss. Chest roentgenogram revealed a huge mass in the posterior mediastinum. The results of needle aspiration cytology from the mass and celiac angiography were suggestive of leiomyosarcoma of the esophagus. The patient underwent tumor enucleation. The tumor originated from the lower-portion of the thoracic esophagus, measured 23 x 13 x 13 cm, and weighted 1110 g. The tumor was diagnosed as leiomyosarcoma histologically. Esophageal leiomyosarcoma is a very rare malignant tumor. The present case had no history of dysphagia in spite of the large tumor size.
 ...
PMID:[A case of leiomyosarcoma of the esophagus]. 180 90

A case of primary small cell carcinoma of the esophagus is presented. The clinical, radiologic, and pathologic findings of our case and 72 other cases were reviewed. The most common presenting symptoms were weight loss and dysphagia. Eighty percent were larger than 4 cm at presentation and 97% were in the mid to distal esophagus. The esophageal tumors were identical histologically to small cell carcinoma of the lung. Esophageal luminal widening on esophagram has been found to be more common in nonsquamous cell carcinomas. While rare, small cell carcinoma should be considered in the differential diagnosis of primary esophageal tumors, particularly in the presence of these findings.
 ...
PMID:Primary small cell carcinoma of the esophagus: case presentation and review of the literature. 184 35

Oesophageal intramural pseudodiverticulosis is a rare condition that presents with dysphagia. The diagnosis is usually not apparent endoscopically and careful radiological evaluation is required. Previous reports suggest a benign course with good response of dysphagia to oesophageal dilatation and complications have not been described. Two cases are reported, one in whom life threatening haemorrhage developed following dilatation, and one complicated by a retro-oesophageal collection. It is possible that oesophageal intramural pseudodiverticulosis results in an increased propensity to trauma and even perforation.
 ...
PMID:Oesophageal intramural pseudodiverticulosis--always benign? 190 31

Esophageal intramural pseudodiverticulosis (EIP) is a rare disease, characterized by multiple, small flask-shaped diverticula in the esophageal wall, and best demonstrated on single-contrast barium examination. Though the condition is often associated with reflux esophagitis, Candida esophagitis, and esophageal dysmotility, corrosive-acid injury is not a commonly recognized cause. In a radiological study involving 59 patients with sequelae of corrosive-acid injury of the upper gastrointestinal (GI) tract, evaluated over a 5-year period, 14 cases (23.7%) of EIP were found. Esophageal stricture was a constant association; the diverticula tended to involve either the entire length of the stricture or its upper part. There was, however, no correlation between the length of the stricture and number of diverticula (p greater than 0.05). Endoscopic dilatation resulted in relief of dysphagia, and the diverticula regressed in number of disappeared altogether. Our experience suggests that EIP is a common sequelae of esophageal acid injuries, and that diverticula tend to form at the site of initial contact between acid and susceptible esophageal mucosa. Stricture dilatation leads to reduction or total disappearance of the diverticula.
 ...
PMID:Corrosive acid-induced esophageal intramural pseudodiverticulosis. A study of 14 patients. 150 Jun 73

Although typically small and submucosal, esophageal granular cell tumors frequently produce dysphagia. Esophageal manometry and a cine-esophagram in a patient with a 7-mm-wide esophageal granular cell tumor and dysphagia showed esophageal aperistalsis and a hypertensive lower esophageal sphincter that relaxed normally with swallowing. This finding suggests that dysmotility may contribute to the dysphagia frequently attributed to this tumor. This tumor is commonly believed to originate from Schwann cells and has a propensity to encompass and disrupt nerves that could produce the abnormal motility. Esophageal manometry is recommended when a small nonobstructing granular cell tumor is found in the evaluation of dysphagia.
 ...
PMID:Esophageal dysmotility from a small esophageal granular cell tumor. 191 49

We report the case of a patient who presented with symptoms of dysphagia, muscle weakness, and photophobia. The diagnosis of sarcoidosis was made by the histologic evidence of widespread noncaseating epithelioid cell granulomas in more than one organ (anterior mediastinal node and right quadriceps muscle). The disease was proven to be active by elevated angiotensin-converting enzyme (ACE) level and gallium-67 imaging. Esophageal dysfunction was demonstrated by barium swallow and manometric study. A review of the literature on sarcoidosis involving the esophagus and the muscular system is presented. Dysphagia and acute symptomatic myopathy are rare presentations of sarcoidosis. The combination of symptoms is unique, and clearly demonstrates the protean multisystemic nature of sarcoidosis. Patients presenting with dysphagia and myopathy should be investigated for sarcoid granulomas in these organs for appropriate treatment.
 ...
PMID:Sarcoidosis: a unique presentation of dysphagia, myopathy, and photophobia. 195 Dec 51

Thirty consecutive patients with globus sensation who were referred to a psychosomatic clinic prospectively underwent otolaryngological, videokinematographic, and manometric examinations of pharynx and esophagus to evaluate whether morphological abnormalities or motility disorders underlay their symptom. When indicated by findings, 24-hour pH-metry, scintigraphy of bolus transport, and esophagogastroscopy were performed. Seven patients were shown to have achalasia, 10 had "hypochalasia" (lower esophageal sphincter relaxation less than 75% with esophageal contraction abnormalities but no complete distal aperistalsis), and 1 had diffuse esophageal spasms; 2 patients had also hyperplastic lingual tonsils, 1 had tonsillitis, and 1 had a cervical spondylophyte. Nutcracker esophagus and nonspecific contraction abnormalities were found in 7 patients, and gastroesophageal reflux with esophagitis and a low lower esophageal sphincter resting pressure was found in 1; only 3 patients had normal esophageal motility. None had volunteered dysphagic symptoms at primary evaluation. Psychometric investigations in consenting patients showed no higher mean scores for state and trait anxiety, depression, hysteria, and hypochondriasis than in general medical outpatients. Esophageal motor disorders may, before giving rise to dysphagia, be sensed more vaguely and induce the globus sensation. However, only disappearance of the sensation after treatment allows inferring an etiological significance of such a disorder.
 ...
PMID:High incidence of esophageal motor disorders in consecutive patients with globus sensation. 195 17

To determine the spectrum of esophageal disease responsible for dysphagia/odynophagia in AIDS patients not responding to current oral antifungals, we studied 49 consecutive patients whose esophageal symptoms failed to improve after a minimum of 3 wk of therapy with oral ketoconazole or fluconazole. An esophageal candidiasis resistant to oral antifungals was the most frequent disease found (22 single infections and four mixed with viruses). Viral esophagitis was identified in 13 cases (eight herpes simplex virus and five cytomegalovirus), and an esophagitis of unknown origin was documented in two patients. Other causes of symptoms included peptic esophagitis (four cases), esophageal stenosis (two cases), and Kaposi's sarcoma of the esophagus (one patient). Most patients with esophageal opportunistic infection experienced prompt relief of symptoms and complete endoscopic resolution on the specific antifungal (amphotericin B or fluconazole iv) or antiviral (acyclovir or gancyclovir iv) therapy, with the exception of those with concomitant fungal and viral infection who responded poorly to treatment. We conclude that most AIDS patients with dysphagia/odynophagia who do not respond to oral antifungals have an opportunistic infection of the esophagus. Nevertheless, specific antifungal or antiviral therapy is worthwhile, because it will eradicate, at least temporarily, the causative pathogens in most such patients.
 ...
PMID:Opportunistic infections of the esophagus not responding to oral systemic antifungals in patients with AIDS: their frequency and treatment. 196 17

The incidence of ulcers of the stomach and duodenum and their response to medical therapy, in patients with Zollinger-Ellison syndrome is well described. However, reflux esophagitis is less well recognized. In this study we determined the frequency of reflux esophagitis in 122 patients with Zollinger-Ellison syndrome and examined their response to medical therapy. Esophageal symptoms, endoscopic abnormalities, or both were present in 61% of patients. Forty-five percent of patients had esophageal symptoms consisting of heartburn, dysphagia, or both. Forty-three percent of patients had endoscopic abnormalities of the esophagus, and 23% demonstrated moderate or severe disease. When sufficient antisecretory medication was administered to lower gastric acid secretion to less than 10 mEq/h in the last hour before the next dose of drug, 67% of the patients with reflux esophagitis responded with complete disappearance of symptoms and normalization of the endoscopic abnormalities. The other 33% of patients required an increase in medication to lower acid output to less than 5 mEq/h in 7% and less than 1 mEq/h in the other 26% to resolve symptoms and signs completely. We conclude that reflux esophagitis occurs in the majority of patients with Zollinger-Ellison syndrome and responds well to medical therapy, although one third of patients require intensive antisecretory medication.
 ...
PMID:Reflux esophagitis in patients with Zollinger-Ellison syndrome. 222 10


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>