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

The congenital ectodermal dysplasias are a rare group of hereditary disorders manifesting with variable defects in structures of ectodermal origin. This report describes a patient with the hypohidrotic form of ectodermal dysplasia who presented with dysphagia and pneumonia. He was shown to have laryngeal incompetence and it is postulated that this may be a mechanism for the recurrent chest infections reported in patients with this condition.
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PMID:Dysphagia in hypohidrotic ectodermal dysplasia. A case report. 646 1

Two case reports are given of patients suffering from malignant melanoma of the esophagus, which occurs very rarely. In both patients the leading clinical symptom was dysphagia. Diagnosis was confirmed by endoscopy and biopsy, and surgery was done. One patient died within 3 weeks from pneumonia, the second patient is alive 3 months after resection of the tumor and is free of symptoms.
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PMID:[Primary malignant melanoma of the esophagus]. 651 13

During the course of 872 thyroidectomies performed at the University of Michigan Medical Center between 1972 and 1982, 50 patients (5.7%) were found to have substernal goiters, 42 of which were benign and eight malignant (16%). Symptoms included airway compression (22 patients), dysphagia (13 patients), hoarseness (four patients), weight loss (three patients), and thyrotoxicosis (10 patients). Five patients with compression symptoms, four of whom had benign disease, had superior vena cava syndrome. Most patients were elderly (mean age 66 years), were women (3.2 women:1 man), and had long-standing goiters (mean duration 16 years). All but one operation was performed through a cervical incision. There were no intraoperative deaths. Complications were: pneumonia (one patient), wound hematoma (one patient), transient hypocalcemia (two patients), and atrial fibrillation (two patients). This series illustrates five reasons to support operative management. (1) There is no other treatment for long-standing large multinodular goiters. (2) Iodine 131, the alternative to operation for patients with large thyrotoxic goiters, can precipitate acute reactions in the elderly that can result in respiratory distress. (3) A long history of having a large multinodular goiter precluded neither malignancy, hyperfunction, nor complications such as tracheal or esophageal compression. (4) Malignancy occurs in a significant number of these lesions, which are inaccessible to needle biopsy. (5) Nearly all substernal goiters can be removed through a cervical incision. Presence of a substernal goiter is in itself an indication for operation.
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PMID:Rationale for the operative management of substernal goiters. 664 12

The association of adenocarcinoma with Barrett's esophagus stimulated a review of our experience to study the clinical presentation, pathology, and results of management. Nineteen patients (15 men and four women) satisfied the criteria of primary adenocarcinoma arising in columnar epithelium in the esophagus. The majority had dysphagia (95%) and weight loss (63%). Nearly three fourths of the patients also had a history of hiatus hernia or esophagitis. Diagnosis was confirmed preoperatively in all by endoscopic biopsy and/or cytologic study. Potentially curative resection was performed in 15 patients and palliative procedures in four. Fourteen patients had advanced (Stage III) disease and only five had Stage I or II disease. Multicentric disease within the esophagus was found in seven patients. Postoperative complications included empyema, hemothorax, and pneumonia (one case each). The only postoperative death resulted from complications of previously undetected brain metastases. The median survival of the 15 patients having resection for cure is 12 months. Four are alive, one with disease at 46 months and three free of disease at 19, 87, and 93 months. All four patients undergoing palliative procedures died within 8 months. The study demonstrates that multifocal presentation of the tumor is common in this group of patients and that long-term survival is possible when early tumors are managed aggressively.
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PMID:Adenocarcinoma in Barrett's esophagus. 682 42

Four cases of pharyngeal trauma in cattle due to improper administration of oral medications are discussed. These cases presented for suspected gastro-intestinal disorders and anorexia. Physical findings included copious drooling of saliva, pharyngeal pain, extended head and neck, forestomach stasis, fever, dysphagia, and pneumonia. Diagnosis was made by manual examination of the oral cavity or endoscopy. Ancillary diagnostic aids included clinical pathology and radiography. Hemograms were consistent with infection, serum electrolytes were normal. Radiographs in 3 of 4 did reveal significant evidence of retropharyngeal cellulitis. The signs of dysphagia and forestomach dysfunction were explained by either a pain induced inhibition of swallowing and eructation or direct involvement of the vagus nerve itself in the retropharyngeal region. An additional consequence of laryngeal motor dysfunction was aspiration pneumonia. Response to treatment with broad spectrum antibiotics, analgesics and symptomatic supportive care over a 7 to 14 day period was good.
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PMID:Pharyngeal trauma in cattle. 722 42

Cricopharyngeal myotomy as an independent procedure has bee performed on 11 patients with a variety of neuromuscular disorders suffering from dysphagia localized to the neck. There was dramatic improvement in nine with one failure and one death from pre-existing pneumonia. The selection of patients for this operation is based on manometric studies.
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PMID:Cricopharyngeal myotomy. 724 30

An 8-year-old girl with a cerebral infarction and pneumonia developed the acute hemiparesis associated with clinical and serologic evidence of Mycoplasma pneumonia infection. Mycoplasma complement fixation titers increased from 1:1,024 on the tenth day of illness to 1:greater than 16,384 at three weeks and subsequently decreased to 1:512 at seven weeks. Total resolution of her facial weakness, hemiparesis, dysphagia and dysarthria occurred by eight weeks.
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PMID:Cerebral infarction associated with Mycoplasma pneumoniae. 724 75

Three foals with chronic cough, bilateral nasal discharge, and pneumonia were found to have a subepiglottic cyst as the inciting cause. Consistent findings were dysphagia and aspiration pneumonia, in addition to the abnormal respiratory noise usually found in the adult horse with a subepiglottic cyst. Histologic examination of the cysts suggested their origin was traumatic rather than embryonic.
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PMID:Subepiglottic cyst in three foals. 742 41

The clinical features of abnormal gastroesophageal reflux in infants and children extend beyond repeated vomiting and include dysphagia, pain, bleeding, failure to thrive, esophageal stricture, and recurrent respiratory symptoms including aspiration pneumonitis and cyanotic attacks. The unreliability of the traditional barium swallow examination as a diagnostic test is well known. This study reports the results of endoscopic assessment and esophageal biopsy in 100 infants and children and relates them to the clinical findings and the changes in the contrast esophagogram. The results show that further valuable diagnostic information can be gained from endoscopic examination of the esophageal mucosa, especially when there is esophagitis with ulceration, bleeding, or stricture. Endoscopic biopsies are useful to confirm the presence of esophagitis but biopsies alone do not give absolute diagnostic information.
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PMID:Endoscopy and biopsy in gastroesophageal reflux in infants and children. 743 49

Surgery for carcinoma of the esophagus and cardia represents potentially curative therapy in early stage of tumor. In the advanced stage of tumor palliation is the only remaining therapeutic aim. In a retrospective study covering the period 1984-1992 we analyzed 51 patients who underwent surgery for esophageal or cardia cancer to determine whether palliation by surgery is feasible. We also analyzed morbidity and mortality of peri- and postoperative complications. In 88% we carried out standard esophagectomy consisting of abdomino-thoracic access, gastric interposition with thoracic anastomosis and extramucous pyloromyotomy. In the light of postresection histology, 53% of the operations were potentially curative (UICC stage I and II) [1], 47% palliative (UICC stage III and IV) [1]. Perioperative 30-days mortality was nil, perioperative 30-days morbidity 11% (3 patients developed pneumonia postoperatively, 2 patients with cervical anastomosis developed dehiscence of anastomosis which in both cases healed completely with conservative therapy, while a further patient with cervical anastomosis suffered persistent paralysis of the recurrent nerve. All patients were fully able to feed themselves at the time of discharge. 43% of patients had recurrent dysphagia and 24% underwent endoscopic dilatation. Three-year survival was 26%. From these results it may be concluded that esophageal resection represents either good palliation with low morbidity for the majority of patients with non-resectable carcinoma of the esophagus or potentially curative therapy with low morbidity in early stage of tumor.
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PMID:[Results of surgical therapy in esophagus and cardia carcinoma]. 752 49


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