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

Tuberculous oesophagitis is a very rare finding; of all organs, involvement of the oesophagus is the least likely. Autopsies on tuberculous patients show an incidence of 0.14%. According to Wexels, only 125 cases have been described in the world literature up to 1954. In general, tuberculous oesophagitis can be included in the differential diagnosis of dysphagia only if this symptom is associated with tuberculosis of an organ, or miliary tuberculosis.
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PMID:[Specific oesophagitis (author's transl)]. 14 65

Ante mortem diagnosis of herpetic esophagitis has been made in four immunosuppressed patients with cancer. The diagnosis was made by brush cytology at the time of esophagoscopy. All four patients had severe dysphagia unresponsive to nystatin therapy and the diagnosis of herpes infection excluded the use of Amphotericin B for resistant moniliasis. The diagnosis of herpes virus infection of the esophagus has been previously made almost exclusively at post mortem examination. Herpetic esophagitis is shown to be not necessarily a preterminal complication in cancer patients. In three of the four patients the esophagitis resolved as the patients responded to anti-tumor therapy.
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PMID:Herpetic esophagitis in patients with cancer: ante mortem diagnosis by brush cytology. 18 38

Twenty-nine patients who underwent Nissen fundoplication for the treatment of symptomatic, sliding, esophageal hiatal hernia are reported. Fourteen of these patients also underwent parietal cell vagotomy (PCV) without a drainage procedure. Simulatenous cineradiography and manometric studies, esophagoscopy and gastric analysis were performed pre- and postoperatively. Esophageal acid clearing and pH reflux studies were performed postoperatively. All but 3 patients had reflux and/or esophagitis preoperatively. Cineradiography and the pH reflux test were the most reliable tests for diagnosis of reflux. There was no operative mortality. The mean followup period was 20 months. Dysphagia occurred in 5 patients. Correction of dysphagia in one patient required operation. The dysphagia in the remaining patients was temporary and mild, responding to dilatation. Two patients had mild diarrhea. One patient who had had a previous gastric resection developed severe diarrhea after bilateral truncal vagotomy. No patient developed the "bloat syndrome". A close correlation did not exist between reflux and preoperative sphincter pressure. The mean LES pressure increased 10 mmH2O postoperatively and the two patients with persistent reflux postoperatively had normal LES pressure. Correction of reflux after Nissen fundoplication is probably due to some mechanism other than increased LES pressure. Recurrent or persistent hiatal hernia was diagnosed in 4 patients by cineradiography. Two of these patients had reflux but only the patient who had undergone PCV was without symptoms or esophagitis. The technical performance of the Nissen hiatal hernia repair was greatly facilitat ed by PCV. This procedure also provided adequate treatment for patients with concomitant duodenal ulcer disease. PCV, unaccompanied by a drainage procedure, was not associated with increased morbidity, mortality or the adverse effects usually attributed to vagotomy. In the event of recurrent hernia and reflux, PCV may prevent the development of esophagitis.
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PMID:Evaluation of the Nissen fundoplication for treatment of hiatal hernia: use of parietal cell vagotomy without drainage as an adjunctive procedure. 23 37

A diagnosis of herpetic esophagitis was made in a patient with alcoholic liver disease by means of endoscopy and brush cytology. Herpetic esophagitis is a common cause of esophageal ulceration in severely debilitated or immunosuppressed patients especially when the esophagus is traumatized by nasogastric intubation. Dysphagia or odynophagia may occur in some but not all patients. Radiographic picture may resemble Candida esophagitis. Endoscopy, biopsy, cytology, culture and serological studies will help in making a diagnosis. Specific antiviral agents may be used for treatment but spontaneous resolution without any sequelae was documented in our patient.
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PMID:Cytologic diagnosis of herpetic esophagitis. A case report. 26 40

Achaiasia cardia is the commonest benign obstructive lesion of the oesophagus in India. We have reviewed 100 cases over a 20-year period. This is the largest series that has been reported from India. Some unusual features were observed. Males were more often affected than females in a ratio of 2.3:1. Children below the age of 10 years are not often affected, but we had 10 subjects in this age group. In our series dysphagia for solids has been the main presenting feature. Barium swallow X-ray studies of the oesophagus were diagnostic. The treatment of choice had been surgical, and a modified Heller's operation has been the chosen procedure. Our preference is for the thoracic approach. Postoperative complications were few. Long-term follow-up of 65 patients over a 19-year period revealed excellent results in 50 patients (76.9%), good results in 10 (15.4%), and fair and poor results in two (3.1%) and three (4.6%) patients respectively. The fair and poor results occurred in patients with recurrence of symptoms or stricture formation due to reflux oesophagitis. The excellent results even on long-term follow-up, we believe are due to the adequate myotomy that was performed.
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PMID:Achalasia cardia: a review of 100 cases. 28 Mar 19

Three cases of esophageal intramural pseudodiverticulosis (EIP) are described and the literature reviewed. We conclude that EIP is an inflammatory disease of unknown etiology characterized by dilatation of the esophageal submucosal glandular elements. The classic radiographic picture which is that of collar-button-shaped outpouchings projecting in a perpendicular fashion from the luminal surface is mainly related to dilatation in the glandular ductal system. It is usually diagnosed in the sixth and seventh decades, but all ages may be affected. Dysphagia is a very common but not universal symptom of the disease process. Approximately one third of these patients have diabetes mellitus. Strictures of the esophagus are frequently seen, and varying degrees of esophagitis may be manifest endoscopically. Esophageal motility disturbances are common and may be severe. Candida infestation with and without tissue invasion has been seen in a number of patients and should be searched for in all cases of EIP.
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PMID:Esophageal intramural pseudodiverticulosis. 40 82

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

The lower esophageal ring, or Schatzki's ring, consists of a thin, submucosal, circumferential scar which forms a thin incomplete diaphragm in the lower esophageal lumen. The symptoms may be either episodic aphagia or progressive dysphagia, and the severity of symptoms is related to the diameter of the ring. Between 1970 and 1978, we saw 24 patients with lower esophageal rings and complaints of episodic aphagia or progressive dysphagia. Symptoms of esophagitis were present in 20 of the 24. Twenty were treated surgically by interrupting the rings and repairing the sliding hiatal hernias. Two were treated by dilatation and two received no treatment to the ring. Hiatal hernias have recurred in two patients. In one, there is a recurrent ring and in the other, an acid peptic stricture. The ring has responded to dilatation and the peptic stricture to dilatation and repair of the recurrent hernia. Two patients without symptoms of esophagitis, treated by dilatation, are doing well but the follow-up period is so far too short to draw any conclusion.
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PMID:Symptomatic lower esophageal ring: treatment of 24 patients. 47 13

Although the lower esophageal ring is an important cause of dysphagia in adults, its pathogenesis is unknown. To better define the relationship between the lower esophageal ring and esophageal reflux, we analyzed, retrospectively, the records of 18 hospitalized patients with radiologically demonstrated rings (16 confirmed by endoscopy and/or surgery). In 16 of these patients, evidence of esophageal reflux including at least one of the following was present: overt esophagitis noted at endoscopy or surgery (14 cases), histologic evidence of esophagitis (3 cases), and/or symptoms of pyrosis or free reflux (13 cases). These findings suggest that 1. reflux is frequently associated with lower esophageal rings and may play a role in their pathogenesis; 2. the radiologic finding of a ring should serve as a clue to the possibility of esophageal reflux and 3. long-term control of dysphagia in these patients may depend upon control of the associated reflux as well as mechanical disruption of the ring.
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PMID:The lower esophageal ring and esophageal reflux. 68 61

A prospective study of 595 patients treated by the Thoracic Surgical Unit (TSU) at the University College Hospital (UCH), Ibadan between July 1975 and December 1977 was carried out to determine the pattern of thoracic surgical diseases in Nigeria and to prove or disprove the rarity of certain cardiopulmonary diseases in tropical Africa. This review shows that pyogenic infections of the lung and pleura constitute the largest percentage (38.5) of the thoracic surgical diseases in Nigeria. Although pulmonary tuberculosis accounts for only 23.4 percent of our total inpatient load, it constitutes about 60 percent of our outpatient clinic practice. Cardiovascular diseases form 12.9 percent, notably congenital and acquired valvular heart diseases. An interesting finding was the occasional association of pyomyositis with pyogenic pericarditis and empyema thoracis. This triad is being investigated. Chest trauma was the most common thoracic surgical emergency accounting for 9.2 percent of the total thoracic surgical pathology. The most common causes of dysphagia are strictures from corrosive esophagitis, achalasia, and carcinoma of the esophagus. Present experience confirms the rarity of hiatus hernia, reflux esophagitis, atherosclerotic cardiovascular disease, and, perhaps, carcinoma of the lung among Nigerians.
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PMID:Pattern of thoracic surgical diseases in Nigeria: experience at the University College Hospital, Ibadan. 70 99


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