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)

It is not unusual for intervertebral disk calcifications to be detected in pediatric practice, the 150 or so cases reported in the literature probably representing only a small proportion of lesions actually diagnosed. Case reports of 33 children with intervertebral disk calcifications were analyzed. In the majority of these patients (31 of 33) a diagnosis of "idiopathic" calcifications had been made, the cervical localization of the lesions being related to repeated ORL infections and/or trauma. A pre-existing pathologic factor was found in two cases (one child with juvenile rheumatoid arthritis treated by corticoids and one child with Williams and Van Beuren's syndrome). An uncomplicated course was noted in 31 cases, the symptomatology (pain, spinal stiffness and febricula) improving after several days. Complications developed in two cases: one child had very disabling dysphagia due to an anteriorly protruding cervical herniated disc and surgery was necessary; the other child developed cervicobrachial neuralgia due to herniated disc protrusion into the cervical spinal canal, but symptoms regressed within several days although calcifications persisted unaltered. These findings and the course of the rare complications documented in the literature suggest the need for the most conservative treatment possible in cases of disc calcifications in children.
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PMID:[Disk calcifications in children]. 403 43

Two cases of ossification of the anterior longitudinal ligament (OALL) associated with diffuse idiopathic skeletal hyperostosis (DISH) presenting as dysphagia are reported. DISH has long been regarded as a radiological entity manifesting flowing ossification adjacent to the anterior and lateral borders of at least four contiguous vertebral bodies, maintenance of disc spaces, and a dearth of bony ankylosis and erosion of the apophyseal and sacroiliac joints. In the majority of cases, this entity shows an innocuous clinical course, but the dysphagia shown in our cases has also been documented in previous literature. Case 1 was a 63-year-old male developing progressive dysphagia and rhinolalia. Cervical X-rays and CT showed flowing OALL in the entire cervical spine. MRI demonstrated displacement of the trachea and esophagus by this mass. There was OALL in the thoracic and lumbar spine. Case 2 was a 62-year-old male who had undergone removal of ossification of the posterior longitudinal ligament (OPLL) from C2 to C5. He developed dysphagia and myelopathy. Cervical X-rays and CT demonstrated projection of OALL as well as posterior osteophytes at C5/6. MRI suggested that OALL had caused dysphagia, and osteophytes deteriorated myelopathy. Removal of OALL was carried out in these two cases. In case 2, removal of the osteophytes and herniated disc was carried out at the same time. Postoperative course was unremarkable with improvement of symptoms. Treatment of dysphagia due to OALL is considered to be conservative. However, surgical decompression should be considered in cases of marked projection of OALL obstructing the esophagus as shown in our cases.
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PMID:[Dysphagia caused by ossification of the anterior longitudinal ligament associated with diffuse idiopathic skeletal hyperostosis: report of 2 cases]. 948 94

Different types of surgical techniques are used for effective treatment of cervical disc prolapse. Techniques with fusion without stabilization have some disadvantages like collapse of the graft, extrusion of graft, nonunion and recurrence of symptoms. We have carried out this prospective interventional study between March 2001 to November 2007 on 129 cases of cervical disc prolapse treated with anterior cervical discectomy, fusion & stabilization with plating at IBN SINA Hospital, Dhanmondi, Dhaka, Al-Manar Hospital, Lalmatia and Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka. There were 106(82.17%) male and 23(17.82%) female patients. The commonest age group of the patients was 4th decade. The commonest level of disc prolapse was found in C5/6 level and in each case, diagnosis was made on the basis of clinical findings, plain X-ray and MRI of cervical spine. We performed anterior cervical discectomy, fusion and stabilization with plating in all cases. A per-operative marking film was taken in each case to identify proper level. Per-operative undue hemorrhage from donor site occurred in 1 case, 27 patients complained of dysphagia temporarily, 64 patients complained of donor site pain significantly which was relieved within 3-6 months of follow-up period. Donor site infection was found in 1 patient. The post operative follow-up period was 3 months to 6 years. The functional out come obtained excellent in 71.43%, good in 19.64%, fair in 8.93%, poor in 2.32% in this series.
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PMID:Treatment of cervical disc prolapse by anterior cervical discectomy fusion and stabilization with plating. 1962 52

Esophageal perforation is a dreaded complication of anterior cervical spinal surgery. A 52-year-old diabetic man had undergone a surgery for a C6-C7 disc prolapse and developed spiking fever with chills and rigor on the 7th postoperative day. No cause could be found out but a CT scan of thorax done in the course of investigations revealed pneumomediastimum. The patient succumbed on the 10th day after surgery. Autopsy revealed the cause of death to be mediastinitis following iatrogenic esophageal perforation. A second patient, 53 years of age, following surgery for C5-C6 disc prolapse and developed intractable dysphagia. Later, fever and purulent discharge from the wound prompted an MRI showing prevertebral collection extending to the superior mediastinum. Presuming only wound infection, debridement and implant removal was done. However persistent serous discharge from the wound revealed an esophageal injury. Late diagnosis precluded primary repair. With conservative treatment, the fistula finally closed after 42 days. Postoperative dysphagia, a common complaint following surgery, may not always be present in cases of esophageal injury. A high index of suspicion is required for diagnosing and initiating treatment for esophageal perforation before complications set in.
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PMID:Two Cases of Esophageal Injury Following Anterior Cervical Discectomy and Fusion: One Overt and One Covert. 2858 68