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

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

Perforation of the cervical esophagus in the course of attempted intubation of the trachea is a very rare accident, or at least rarely reported. Over the past 11 years, 12 patients ranging in age from 44 to 72 years were treated in our unit. If suspected, esophageal perforation is easy to diagnose when intubation has been difficult or when the patient complains of dysphagia and neck pain. Subcutaneous cervical emphysema appears early. All the patients who were operated upon early made an uneventful and prompt recovery. In those subjected to delayed operation (more than 12 hours) or nonoperative treatment, the mortality rate was 56 percent and recovery was achieved only after long and difficult treatment.
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PMID:Esophageal perforation during attempted endotracheal intubation. 44 86

Two patients with closed rupture of the cervical trachea secondary to blunt trauma, one secondary to neck injury and the other secondary to thoracic injury, were analysed with those reported else where (58). Signs and symptoms included subcutaneous emphysema, respiratory distress, hoarseness/dysphonia, dysphagia, hemoptysis and so on. We conclude that: (1) the diagnosis of blunt trauma of the cervical trachea requires a high index of suspicion, since this injury can easily be overlooked; (2) tracheostomy is the best means of airway control; (3) good long-term airway quality is best obtained by immediate repair of injuries.
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PMID:[Closed rupture of the cervical trachea]. 130 96

Life threatening mediastinitis as a complication of acute epiglottitis is very rare. A 38-year-old male in previously good health was admitted to our hospital in a state of unconsciousness. Seven days prior to admission he had complained of a sore throat, dysphagia, high fever and dyspnea. A chest X-ray on admission showed widening of the mediastinum, mediastinal emphysema, subcutaneous emphysema and left pleural effusion. Bronchoscopy showed the swelling of supraglottic structures. He was diagnosed as having acute mediastinitis and pyothorax as a complication of acute epiglottitis, but pathogens were not identified. The blood was hyperglycemic and insulin therapy was started. Though he gradually improved by massive antibiotic therapy, steroid therapy, tracheotomy and surgical drainage of both the left thoracic cavity and the mediastinum, he died suddenly of massive hemoptysis. Autopsy revealed that the acute mediastinitis had healed, but that the Aspergillus infection was present in both lungs and the pericardium. The Aspergillus infection was not lethal in the present case, and it seemed that death had resulted from arterial hemorrhage caused by erosion of the trachea. The present case suggests the need for antifungal therapy even in non-immunocompromised patients in particular when massive doses of antibiotics and steroids are administered.
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PMID:[A case of mediastinitis and bilateral pyothorax, following acute epiglottitis with concurrent Aspergillus infection]. 140

A 20-year-old female developed dysphagia, chest pain and numbness of the left arm after dinner on August 22, 1990. She consulted a doctor, who diagnosed tachycardia and prescribed propranolol. On August 23, she hadn't improved. On the same day, she visited our hospital. Chest X-ray films revealed lucent band and distinct line running parallel to the border of the heart and we suspected mediastinal emphysema. Immediately we took chest CT scan, which demonstrated free air surrounding the trachea, thoracic aorta and heart. We diagnosed spontaneous mediastinal emphysema. She was treated with bed rest and mediastinal emphysema subsided within 8 days. The numbness in the patient's arm is an unusual symptom in mediastinal emphysema. We suggest that the numbness of the arm may be due to interference with the circulation to the arm by distention of the mediastinal tissue.
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PMID:[A case of spontaneous mediastinal emphysema developed by numbness of the left arm, dysphagia and chest pain]. 148 Aug 36

Pneumomediastinum is a rare pathological condition with air in the mediastinum outside the trachea and oesophagus. The etiology may be spontaneous/resulting from exertion, traumatic, iatrogenic or it may be due to inflammation, neoplasm or perforation of a hollow abdominal organ. In pneumomediastinum resulting from exertion, a pressure gradient occurs and this causes rupture of marginally situated pulmonary alveoli. Air escapes from the alveoli into the perivascular adventitia and dissects its way along the vessels to the mediastinum. The commonest symptoms are pain in the thorax in 80-90% of the patients, followed by sensation of oppression and dysphagia. Stethoscopic examination reveals crepitation synchronous with pulse and respiration in half of the cases. The diagnosis is verified by radiographic examination of the thorax where air can be seen as vertical radio-translucent regions in the mediastinum and along the borders of the heart. Patients with pneumomediastinum should be admitted to hospital for investigation as treatment of a possible basic condition, e.g. rupture of the oesophagus or bronchus, is important. In uncomplicated cases, the mediastinal emphysema disappears in the course of a week. Mediastinotomy with incisions for relief of pressure may prove necessary.
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PMID:[Pneumomediastinum]. 150 65

The experience of diagnosis and treatment in 15 patients with mediastinal abscess was introduced in this paper. Most mediastinal abscesses are the results of secondary infection. One of the main causes is esophageal perforation. The main clinica manifestations are fever, chest pain, dysphagia and dyspnea. A toxic shock develops in serious cases. Chest X-ray examination is an important diagnostic method showing widened mediastinum, air-fluid level in mediastinum and subcutaneous emphysema. The writer holds that once diagnosis is made, an adequate drainage of abscess should be made by individualized route of entry. In order to maintain enough nutrition, gastrostomy should be performed followed by tube feeding. In this series, the above mentioned treatment regime gave quite satisfactory result. Twelve of the 15 cases got cured or improved. Three cases failed to respond and died.
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PMID:[Diagnosis and treatment of mediastinal abscess]. 208 54

A case of retropharyngeal emphysema associated with drug abuse is presented. Although chest symptoms of pneumomediastinum have been widely reported with substance abuse, pain localized to the neck is rarely described. In the present case, localized dysphagia was the only complaint, and no free air could be demonstrated within the thorax. For uncomplicated cervical emphysema or pneumomediastinum due to substance abuse, extensive workup may be unnecessary, and conservative therapy, including administration of 100% oxygen and observation is recommended if resolution is prompt.
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PMID:A simple sore throat? Retropharyngeal emphysema secondary to free-basing cocaine. 209 67

The hypopharynx and cervical esophagus are particularly vulnerable to intubation trauma. Contributing factors include hasty intubation by inexperienced personnel; the use of curved, beveled endotracheal tubes containing stylets; malpositioning of the head, and the application of cricoid pressure. Iatrogenic pharyngoesophageal perforations may go unsuspected until characteristic signs and symptoms are recognized. These include cervical pain, fever, dysphagia, leukocytosis, subcutaneous emphysema, and pneumomediastinum. We present three cases that illustrate important points in recognizing, evaluating, and treating pharyngoesophageal perforations. The third case presents a chronic cervical esophageal perforation with secondary pseudodiverticulum, requiring resection of the pseudodiverticulum and a primary sternocleidomastoid muscle flap repair of the cervical esophageal defect. To our knowledge, this technique has not previously been reported.
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PMID:Pharyngoesophageal intubation injuries: three case reports. 224 Apr 14

With the aim of suggesting incision of peptic esophageal strictures, as an alternative to bougienage, we report the results of the first 20 patients so treated. We included as candidates for this treatment all those patients with moderate or severe dysphagia in whom a stricture of the distal esophagus was confirmed on esophagoscopy that could not be negotiated despite continuous and vigorous pressure with the tip of the fiberscope. On the basis of radiological films, the minimum diameter of the stenotic ring (+/- SD) was 4.4 +/- 2.2 mm, increasing up to 10.05 +/- 1.5 mm once the endoscopic procedure was made. Dysphagia was initially relieved in all the cases. Four patients had recurrence within a few days after the incision. Later, another 4 patients had recurrence. Finally, a further 4 cases were lost by non-compliance. The remaining 8 patients who underwent a 6-months' follow-up did not show a later tendency to re-stenosis. In total, 5 patients were surgically treated for hiatal hernia. One case of emphysema in the mediastinum was noted and treated conservatively. We conclude that endoscopic incision is an alternative to esophageal dilatation as initial treatment for peptic esophageal stricture, despite the fact that a significant number of patients will require additional surgical correction for gastro-esophageal reflux.
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PMID:Endoscopic incision as an alternative to bougienage in the treatment of peptic esophageal stricture. 235 32


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