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)

A 19-year-old Negro female, gravida 2, para 1, was presented at the Queen Elizabeth Hospital in Barbados, West Indies with difficulty opening her mouth; bleeding, and spasms of the skeletal muscles. A week before, she had undergone an illegal abortion performed by a friend. Curettage; tracheostomy; and passage of a nasogastric tube under general anesthesia were performed after admission. Antitetanus serus; high doses of diazepam; promazine for sedation; and antibiotics were administered. Curarization; assisted ventilation; and maintenance of nutrition through parental fluids were observed. Bilateral pneumothorax; tachycardia; and hypotension complicated the patient's course. The patient was discharged on the 40th day of hospitalization and was advised to visit the medical and gynecology clinic for follow-up examination and completion of tetanus immunization. Factors critical in the management of postabortal tetanus patients include: 1) recognition of classical signs of trismus; risus sardonicus; dysphagia and increased muscular tone and spasms; 2) use of antitetanus serum after sensitivity testing; 3) antibiotic coverage for clostridia and anaerobic organisms; 4) tracheostomy; curarization and assisted ventilation where necessary; 5) continuous medical and nursing care in a quiet room; 6) adequate hydration and nutrition; 7) treatment of site of injury, and curettage where necessary; 8) hysterectomy where necessary; and 9) post treatment immunization.
Conn Med 1975 Dec
PMID:Post-abortal tetanus. 120 40

A 57-year-old woman suffered from polyarthralgia for 7 years, and was treated by using NSAID with the diagnosis of RA. From Jan. 20th 1987, she complained of back pain and numbness of both hands, and from May 7th 1987, she also complained of dysphagia and dysarthria, and she was not able to button up. Soon afterwards she could eat only one custard pudding a day, so she admitted to our hospital on March 17th 1987. The neurological examination showed hyporeflexia and muscle weakness of the four extremities; and hypesthesia of the 7th to 11th intercostal nerve area and both lateral sides of the dorsum pedis. The laboratory examination showed ESR 17 mm/h, gamma-glob 1.66 g/dl, CRP(+), RAHA 80 x, CH50 24.0 U/dl, HLA-antigen; DR 4(+). Cerebrospinal fluid examination showed cell 5/mm3, protein 63 mg/dl, IgG 13 mg/dl, IgG% 20.6%. X-ray examination indicated destruction of both wrists, left elbow, right 2-5th MTP, and left 5th MTP joints. A light microscopic examination of the left sural nerve showed perivascular infiltration with lymphocyte, occasional macrophages and giant cells at the epineurium, and no demyelination or Wallerian degeneration at the nerve fiber. These histological findings were the same as type-I arteritis in nerves in RA proposed by D.L. Conn. Clinical improvement was obtained after administration of prednisolone 30-60 mg/day.
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PMID:[A case of rheumatoid arthritis associated with polyneuritis]. 266 32

The circular stapler has lowered the leakage rate of an esophageal anastomosis to a level hitherto achieved by only a few surgeons performing hand anastomosis on selected patients with carcinoma of the esophagus. However, the esophageal anastomosis performed with a stapler is also associated with a high stricture rate. Our prospective study was conducted to determine the leakage rate and the incidence of stricture after esophagogastric anastomosis was performed with a stapler, the relationship of stricture to the size of the stapler, and the risk of stricture in relation to time. In a group of 174 patients with carcinoma of the thoracic esophagus, resection was performed, and a one-stage esophagogastric anastomosis was constructed. There were 33 hand anastomoses, 64 anastomoses with an EEA stapler (U.S. Surgical Corp., Norwalk, Conn.), and 77 anastomoses with an ILS stapler (Ethicon Ltd., Edinburgh, U.K.). The anastomotic leakage rate was 3.4% (6/174); 3% with the hand technique and 3.5% with the stapler technique (4.7% for the EEA and 2.6% for the ILS). After leakages and hospital deaths were excluded, 133 discharged patients were evaluated for the occurrence of anastomotic strictures. Only those who complained of dysphagia were investigated. The incidence of stricture for hand anastomosis was 8.7%-EEA 20% and ILS 10%; the overall incidence of anastomoses with a stapler was 14.5%. The true incidence would probably be higher if all patients were assessed by endoscopic or radiologic examination after operation. All three sizes of EEA staplers had a high incidence of stricture. For the ILS stapler the 25 mm size had the highest stricture rate (28.6%) of all groups, but for the 29 and 33 mm sizes, the incidences were 5.3% and 0%, respectively. Actuarial analysis showed an increasing risk of stricture with a reduction in the size of stapler used and was 32.5% and 35%, respectively, for the ILS 25 mm and EEA 25 mm staplers at 131/2 months. The risk of stricture occurrence was highest in the first 4 months. Treatment by bougienage was satisfactory. In conclusion, esophagogastric anastomosis performed with a stapler is a very safe procedure with respect to leakage but is associated with a high risk of stricture, except when the largest ILS staplers are used. However, dilatation readily overcomes the stricture occurrence and adequately compensates for the reduced leakage rate and its attendant serious consequences.
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PMID:Esophagogastric anastomosis performed with a stapler: the occurrence of leakage and stricture. 356 86

An apparent reduction in the rate of benign anastomotic stricture after stapled esophagogastrectomy prompted us to review the results obtained with different stapling devices since 1988. We present a retrospective review of 125 consecutive patients undergoing esophageal resection for malignancy with stapled intrathoracic anastomoses. Benign anastomotic stricture was deemed present when a patient required endoscopic dilatation to treat postoperative dysphagia. We found no difference in risk factors not related to stapler size (tumor histologic characteristics, adjuvant therapy) between patients with stricture and patients without stricture. Event-free survival was compared for different stapler diameters as well as for different stapler designs. We found that staplers of smaller diameter were associated with significantly more strictures (p < 0.005). In a comparison of different designs of 25 mm stapler, the newer CDH device (Ethicon Ltd., Edinburgh, United Kingdom) was associated with a similar stricture rate to that associated with other designs (ILP [Ethicon] and EEA [Autosuture Company Division, United States Surgical Corp., Norwalk, Conn.]). For a given stapler diameter, it appears that different stapler designs have no effect on stricture rate.
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PMID:Stapler design and strictures at the esophagogastric anastomosis. 855 59

Anterior cervical osteophyte is a rare cause of dysphagia usually occurring in the elderly. We report two cases in which the anterior cervical osteophytes impinged upon the esophagus, and we describe their surgical management. Initial investigation of a case of dysphagia should be directed to the common causes; however, in the elderly and in those with disorders of the cervical spine an anterior cervical osteophyte may be the cause of dysphagia.
Conn Med 1997 Jun
PMID:Anterior cervical osteophytes: a rare cause of dysphagia. 923 25

Oropharyngeal dysphagia in adults is secondary to either a structural lesion or neuromuscular disorder of the upper esophageal sphincter. In cricopharyngeal achalasia (incomplete relaxation of the upper esophageal sphincter), the etiology is usually either related to neck surgery or other neuromuscular disorders. We report on a rare case of neuromuscular oropharyngeal dysphagia secondary to bone metastases to the base of the skull. The patient is an 81-year old man with prostate cancer with metastases to the sacrum. A gastroscopy was attempted to discern the etiology of his dysphagia, but the endoscope could not be advanced. A barium swollow showed cricopharyngeal achalasia, and an magnetic resonance image of the brain demonstrated bone destruction to the floor of the left posterior fossa in the region of the jugular foramen and foramen magnum. The bone destruction caused disruption of the glosso-pharyngeal and vagus nerves. Selective radiotherapy resulted in rapid improvement in his symptoms. The primary treatment of cricopharyngeal achalasia is to correct the underlying process, if possible. This case illustrates an unusual presentation of secondary cricopharyngeal achalasia caused by cranial nerve involvement secondary to bone metastases.
Conn Med 1998 Aug
PMID:Neuromuscular oropharyngeal dysphagia secondary to bone metastases. 975 2

A 13-year-old castrated male cat was examined because of a 2-week history of weakness, cervical ventroflexion, and dysphagia. Clinicopathologic abnormalities included hypokalemia and high serum creatine kinase activity. Abdominal ultrasonography revealed a 15-mm spherical mass in the area of the left adrenal gland. Plasma aldosterone concentration was high, and plasma renin activity was low. Findings were diagnostic of primary hyperaldosteronism. The cat responded well to intravenous and oral potassium supplementation while in the hospital. The owner declined surgery; therefore, repeated follow-up abdominal ultrasonography was recommended. The cat did well clinically with medical management alone until day 334, when it was lost to follow-up.
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PMID:Use of abdominal ultrasonography in the diagnosis of primary hyperaldosteronism in a cat. 1090 61

Toxic epidermal necrolysis (TEN) is an idiosyncratic, potentially life-threatening skin disease characterized by widespread inflammation and necrosis of the epidermis and mucous membranes. It may result in narrowing of the esophageal lumen through fibrosis and esophageal stricture in rare situations, mostly encountered in children. To the best of our knowledge, we report the first case of esophageal stricture secondary to allopurinol-induced TEN in an adult patient. A 70-year-old male presented to our clinic with severe dysphagia secondary to allopurinol-induced TEN involving his mouth and esophagus. At the time of presentation the patient had a percutaneous endoscopic gastrostomy feeding tube and was unable to handle his oral secretions. Endoscopy revealed near complete proximal esophageal stricture. A bidirectional esophageal dilatation procedure via the mouth and percutaneous endoscopic gastrostomy site was successfully performed over a guidewire for treatment of this patient. The patient tolerated the procedure well. Esophagogastroduodenoscopy with dilation was performed in a regular anterograde fashion five times over the next three months. Triamcinolone acetonide was injected using Carr-Locke injection needle from ultrasound endoscopy during the last three sessions. He currently tolerates a regular diet without difficulty.
Conn Med 2013 Oct
PMID:Esophageal stricture secondary to drug-induced toxic epidermal necrolysis presenting in an adult: an unusual complication of a rare disease. 2427 4

We report an extremely rare case of primary glomus tumor of the esophagus, and review the corresponding literature. A 66-year-old female underwent a follow-up upper-gastrointestinal endoscopy due to dysphagia and previous history of esophageal lump. Endoscopic ultrasonography revealed a mass involving the deep mucosa and submucosa (Layers 2 and 3). Endoscopic biopsy revealed a mesenchymal tumor composed of nest of epithelioid cells with associated small blood vessels proliferation. Immunohistochemically, the tumor cells were positive for alpha smooth muscle actin and vimentin, but negative for c-kit and the vascular stroma was highlighted by positivity with CD34. Pathological examination confirmed that the tumor was a glomus tumor of the esophagus. The patient remains healthy without any recurrence to date.
Conn Med 2015 Feb
PMID:Glomus Tumor of the Esophagus: A Case Report and Review of the Literature. 2624 7

A simple-to-administer test for dysphagia was developed at our institution. The test can be administered rapidly and easily in the Emergency Department (ED) by a nurse or other qualified medical person, making formal consultation with a speech pathologist for rapid determination of dysphagia unnecessary. Our study shows that the use of the test does not increase the incidence of aspiration pneumonia.
Conn Med 2016 Apr
PMID:CVAS: A Rapid Dysphagia Evaluation Tool. 2726 22


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