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

Dysphagia due to secondary involvement of the oesophagus by pancreatic carcinoma is relatively rare. Occasionally, the oesophagus may be involved by direct extension of a carcinoma of the body and/or tail of the pancreas or metastatic lymphadenopathy in the posterior mediastinum. Although the literature contains a few case reports in which barium studies revealed displacement or obstruction of the distal oesophagus, a benign-appearing, smooth, tapered narrowing of the distal oesophagus with a fixed, right-angled configuration is a radiological finding which has not been previously emphasised. In the author's experience, this abnormality may be a helpful radiological clue to the diagnosis of carcinoma of the tail of the pancreas. The clinical, radiological and pathological findings in four patients with dysphagia and a right-angled narrowing of the distal oesophagus secondary to carcinoma of the tail of the pancreas are described and illustrated; the radiological differential diagnosis is briefly discussed.
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PMID:Right-angled narrowing of the distal oesophagus secondary to carcinoma of the tail of the pancreas. 42 21

An enameler with dysphagia was found to have extrinsic compression of the esophagus by enlarged mediastinal lymph nodes. Scalene lymph node biopsy revealed silicosis, and tissue cultures grew Mycobacterium intracellulare. We believe our patient is the first reported to have dysphagia due to silicotic adenopathy complicated by an atypical mycobacteriosis.
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PMID:Esophageal compression in association with silicosis and Mycobacterium intracellulare. 51 11

Eleven malignant thyroid tumors were found in 100 consecutive patients more than sixty years old having thyroid operations. Based on preoperative findings, these 100 patients could be separated into two groups according to high and low risk for malignancy. Clinical manifestations in the high risk group were presence of a discrete cold thyroid nodule, hoarseness, dysphagia, an enlarging mass, or palpable ipsilateral cervical adenopathy; and in the low risk group, asymptomatic multinodular goiter, diffusely enlarged glands with elevated antithyroid antibody titers, and a family history of goiter. All eleven patients with malignant thyroid tumors were found in the sixty-six patients considered at high risk, whereas no malignant lesions were found in the low risk patients. Six of the malignant thyroid tumors were undifferentiated and in three of these a thyroid nodule had been present for more than fifteen years. There were no operative deaths and only one significant complication, a recurrent laryngeal nerve injury. Thyroidectomy is indicated for elderly patients with thyroid nudules who have features of the high risk group, whereas patients in the low risk group can be safely followed.
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PMID:Management of thyroid nodules in the elderly. 98 6

A 41-year-old woman manifested a polyneuropathy, anasarca, pseudotumor cerebri, hyperhidrosis and hyperpigmentation of the skin, generalized lymphadenopathy, distal esophageal dysphagia, pleuritis, platelike pulmonary atelectasis, fluctuating renal insufficiency, hepatosplenomegaly, amenorrhea, and slight fever suggesting a connective-tissue disorder. Extensive clinical and laboratory evaluation did not support the initial impression of progressive systemic sclerosis or systemic lupus erythematosus but did show nonnecrotizing vascular changes, mild polyclonal gammopathy, and low thyroxin levels similar to the syndrome of polyneuropathy and endocrine disturbances recently reported from Japan. The impressive response to moderate-dose corticosteroids and exacerbation on withdrawal require diagnostic awareness of this insidiously progressive multisystem disorder. A bland vasculopathic process resulting from metabolic or immunologic disturbances appears to be the best explanation for this new syndrome, which has previously been recognized only in Japan.
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PMID:Polyneuropathy and anasarca: evidence for a new connective-tissue syndrome and vasculopathic contribution. 125 61

Percutaneous gastrostomy (PG) was performed on 18 patients and 11 patients were subjected to surgical gastrostomy (SG) in the HCU of Zaragoza from October 1990 to November 1991. Involvement of the high digestive tract was the most common finding: 11 patients had CA of the oesophagus and stomach, 2 suffered from extrinsic pressure of the oesophagus due to metastatic adenopathy of a lung and breast tumour and 9 patients had CA of the larynx with total dysphagia. Another less common indication in our series, although still of great importance, was a severe involvement of the CMS, which made oral nutrition impossible due to functional dysphagia. Due to the long-term nature of this pathology, feeding by nasogastric tube was not considered. This was the case of 4 patients. The duration of enteral nutritional in the patients' home was 112.8 +/- 61 days with PG and 37 +/- 26 days with SG (p: 0.007). The incidence of complications was 33% in PG and 73% in SG, and for both techniques, the most common complication was blockage of the tube. Percutaneous gastrostomy is a simple technique, with no surgical risks involved, but with the benefits of traditional surgical techniques which, despite the small number of cases recorded, has very few complications both with regard to placing and afterwards, and also enables the patient to receive nutrients earlier than would be the case with traditional surgical techniques during prolonged periods at the patient's home.
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PMID:[Percutaneous and surgical gastrostomies: our clinical experience in enteral nutrition]. 142 Apr 88

Oesophageal tuberculosis secondary to tuberculous mediastinal lymphadenopathy is a very unusual presentation of adult tuberculosis. We report a young patient who presented with anorexia and weight loss. The chest radiograph and CT scan revealed mediastinal lymphadenopathy causing extrinsic oesophageal compression on the barium swallow. This was confirmed by upper gastrointestinal endoscopy. Four weeks later, because of spontaneous partial relief in dysphagia, upper gastrointestinal endoscopy was repeated and revealed an ulcerated lesion with nodular margins at the mid-oesophagus. Biopsy from the ulcer margin revealed non-caseating granulomas. The patient had complete relief of dysphagia and other symptoms within 3 weeks of start of antituberculosis therapy.
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PMID:An unusual presentation of oesophageal tuberculosis. 142 52

Tuberculous infection of the oesophagus is rare. This is confirmed by our present review of cases managed in our teaching hospitals over a period of 18 years which uncovered only 11 patients. The main presentation is that of dysphagia whose algorithm of investigation should seek to differentiate tuberculosis from carcinoma, the more common cause of this symptom. Of the 11 patients, 9 presented with dysphagia while 2 had haemorrhage; 7 had an abnormal plain chest radiograph, of whom 4 had a mediastinal mass lesion (3 were lymphadenopathy and one an abscess). All but one had an abnormal radio-contrast oesophagogram, including a mediastinal sinus in two and a traction diverticulum in another two. The mainstay of investigation was oesophagoscopy through which diagnostic biopsy material was obtained in half of the patients. In the other half diagnosis was by either biopsy of associated mediastinal (3) or cervical (1) lymph node masses or by acid fast bacilli positive sputum (1). The diagnosis was established post-mortem in one patient. Treatment was primarily non-operative with standard anti-tuberculosis drug therapy. Two patients underwent a diagnostic thoracotomy and one a drainage of mediastinal abscess together with resection and repair of oesophago-mediastinal sinus during the early part of the series. Outcome of management was very rewarding in 9 patients and death occurred in 2 patients, one of whom had his anti-tuberculosis drug therapy interrupted by severe hepatitis B virus infection. The other death occurred in a patient whose haemorrhage from an aorta-oesophageal fistula was not established ante-mortem. It is recommended that when biopsy material of the oesophagus is unobtainable or non-diagnostic in patients with dysphagia, especially with an abnormal chest radiograph or human immunodeficiency virus infection, effort should be made to obtain biopsy material from associated lymph nodes, even by thoracotomy if necessary, or culture of biopsy from the radiologically abnormal part oesophagus and sputum for mycobacteria, in order to establish the diagnosis of this rare but eminently treatable cause of dysphagia. Clinicians should be aware of tuberculosis of the oesophagus as a possible cause of haematemesis in patients with otherwise unexplained upper gastrointestinal haemorrhage.
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PMID:Oesophageal tuberculosis: a review of eleven cases. 157 Feb 50

The fine needle aspiration (FNA) cytology of a recurrent multifocal extracardiac adult rhabdomyoma is described, and the literature is reviewed. The patient presented with dysphagia and bilateral palpable neck masses 21 yr after resection of a rhabdomyoma of the tongue. The clinical differential diagnoses included ptotic submandibular glands and lymphadenopathy. The aspiration smears and cytospin preparations contained large polygonal cells with abundant granular cytoplasm with indistinct borders and uniform, peripherally located nuclei. Cross-striations were identified within the cytoplasm of some cells on Papanicolaou and modified Wright-Giemsa stains. This case represents only the fourth description of the cytology of this entity and the first reported case of a recurrence diagnosed by FNA. The characteristic cytomorphologic features enabled a definitive diagnosis to be made 21 yr after the original resection, sparing a poor-risk patient a debilitating surgical procedure for a benign, slow-growing neoplasm.
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PMID:Recurrent multifocal adult rhabdomyoma diagnosed by fine-needle aspiration cytology: report of a case and review of the literature. 170 99

Fifty to eighty per cent of patients with AIDS-related complex or AIDS have gastrointestinal symptoms, the most common being dysphagia, diarrhea, or perianal lesions. The symptomatology varies from a mild "gay bowel syndrome" to a severe "diarrhea wasting syndrome". In patients with lymphadenopathy syndrome and AIDS the mucosal CD4/CD8 ratio is decreased, and the IgA-producing plasma cells of the mucosa are diminished in number as compared with HIV-negative controls. AIDS enteropathy, the etiology of which remains unclear, seems to be associated with direct infection of the intestinal mucosal cells with HIV. Clinical and therapeutic aspects of some opportunistic infections, such as Candida albicans, cytomegalovirus, and Herpes simplex virus-infection are discussed in this part.
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PMID:[Gastrointestinal manifestations of AIDS. 1: Basic considerations and viral infections]. 185 16

A double-blind, placebo-controlled study was carried out in 231 adult patients suffering from acute diffuse pharyngitis or acute tonsillitis with fever and dysphagia to assess the effectiveness of niflumic acid combined with standard antibiotic therapy in relieving pain and inflammation. Patients were allocated at random to receive either 4 capsules of 250 mg niflumic acid or placebo daily in addition to 1.5 million units phenoxymethyl penicillin for 4 to 5 days. Clinical assessments before and after 2 and 4 days of treatment showed that there was faster resolution of fever, pain, adenopathy, pharyngeal congestion and dysphagia, and improved patient comfort in the niflumic acid group. Few side-effects were recorded and there were only 4 drop-outs due to side-effects in patients receiving niflumic acid.
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PMID:Double-blind, placebo-controlled, multi-centre trial of the efficacy and tolerance of niflumic acid ('Nifluril') capsules in the treatment of tonsillitis in adults. 210 60


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