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

A case of myasthenia gravis accompanied with polymyositis and malignant thymoma, detected immune complexes in the sera and around the muscle fibers, was described. A 37-year-old woman was admitted to Shinshu University Hospital in September, 1987 because of dyspnea, dysphagia and muscle weakness. She first noticed her right blepharoptosis 3 weeks before admission. Weakness of all four limbs and myalgia of lower extremities were noticed one week later. These symptoms got worse and nocturnal dyspnea, dysphagia and easy fatigability at mastication appeared. On admission, she looked ill and neurological examination revealed left blepharoptosis, bilateral facial weakness, weakness of all four limbs, more prominent in proximal muscles and tenderness of lower extremities. Edrophonium test was positive, improving her muscle weakness. Laboratory examination revealed the elevated serum levels of CK, the increased titre of circulating immune complexes and high titres of acetylcholine receptor antibodies and anti-skeletal muscle antibodies. Electromyographic study showed myogenic pattern and Harvey-Masland test revealed waning at low frequency stimulation. Muscle biopsy showed marked perivascular infiltration of lymphocytes, accompanied by phagocytosis and interstitial fibrosis. IgG deposits were shown around the muscle fibers exclusively around the infiltrates of mononuclear cells. Granular deposits of C3 were also shown specifically around the muscle fibers exclusively around the infiltrates of mononuclear cells. Thymectomy was performed on September 21, 1987. Invasion of thymoma, predominantly lymphocytic type, to right lung and pericardium was observed histologically. After thymectomy, she got better. Immunological data and immunohistochemical examination of the present case suggest that in the case of myasthenia gravis accompanied with polymyositis and malignant thymoma, immune complexes may play a primary role on the pathogenesis of myositis.
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PMID:[Detection of immune complexes in the sera and around the muscle fibers in a case of myasthenia gravis and polymyositis]. 253 18

Our retrospective study is based on 80 compressive goitres collected over a period of 7 years in the general surgical department of the Ibnou Rochd University Teaching Hospital, Casablanca. Dyspnea was the predominant clinical manifestation and was encountered in 82.5% of cases, followed by dysphonia (65%), dysphagia (46%) and finally venous compression (8.7%). Hyperthyroidism was encountered in 26.25% of cases, 57% of these being due to Grave's disease. The goitre extended mediastinally in 38% of cases but resection was possible on cervicotomy alone. Post-operative sequelae were minor in nature, though one death did occur. On histological examination 85% of these goitres were benign and only 15% were of a malignant nature. This is in agreement with the data in the literature which confirms that compression is not synonymous with malignancy.
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PMID:[Compressive goiters. Apropos of 80 cases]. 259 60

Phrenic nerve palsy secondary to benign thyroid enlargement is a previously unreported complication. Large goiters, particularly substernal, may impinge upon adjacent structures, often leading to significant symptoms such as dysphagia or dyspnea due to airway compression. The phrenic nerve may be stretched by a large goiter along its course in the neck, but the more likely site of injury is the point at which it enters the thoracic cavity adjacent to the first rib. Such an injury, caused by compression, may go unrecognized if unilateral, as symptoms would be uncommon. However, bilateral phrenic nerve palsy can cause significant dyspnea due to pulmonary insufficiency, particularly in an elderly patient with cardio-pulmonary disease. Early operative treatment of the goiter may prevent this complication or limit its severity, thus avoiding permanent nerve injury.
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PMID:Bilateral phrenic nerve palsy associated with benign thyroid goiter. 259 52

Localized thyroid carcinoma involving the base of the tongue was diagnosed in 3 dogs examined because of a midline cervical mass rostroventral to the larynx. These masses had been present for 4 to 12 months and were firm, nonsensitive, and fixed in position. One dog had progressive dysphagia and dyspnea. Masses were surgically excised together with the base of the tongue and portions of the hyoid apparatus. Severe dyspnea that developed immediately after surgery in 1 dog was managed by tracheostomy intubation for 4 days. Transient dysphagia developed in all dogs. Hydration was maintained by IV fluid administration until water and food of gruel consistency could be swallowed 1 to 6 days after surgery. Consistency of food was gradually thickened to normal, as swallowing improved 6 days to 2 months after surgery. One dog developed aspiration pneumonia that resolved after antimicrobial administration and improved swallowing that prevented further aspiration. After 9 months, 3 years, and 6 years, the dogs were clinically normal.
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PMID:Surgical excision of ectopic thyroid carcinoma involving the base of the tongue in dogs: three cases (1980-1987). 259 48

Aspiration can lead to serious pulmonary disease and occasionally death. Substances aspirated commonly include bacteria or gastric contents or both, but may be as unusual as diesel oil or a variety of foreign bodies. Pulmonary symptoms range from a subtle cough, wheezing, or hoarseness to severe dyspnea or asphyxiation. We discuss the mechanism of pulmonary disease caused by aspiration as well as the appropriate treatment.
Dysphagia 1989
PMID:Pulmonary consequences of aspiration. 263 73

Two children with symptoms of dysphagia, dyspnoea and chronic pulmonary infections secondary to anomalies of the aortic arch are presented. Diagnostic procedures included oesophagography and aortic arch angiography. These showed a double aortic arch in the first child and an aberrant right subclavian artery in the second one, leading to compression of both trachea and oesophagus. Both children underwent surgery: in the first child the atretic anterior arch and the left ligamentum arteriosum were divided; in the second child the aberrant right subclavian artery was divided at its origin from the descending aorta and connected to the ascending aorta. Follow-up examinations showed a complete recovery of both patients.
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PMID:[Congenital vascular rings in children]. 264 53

This report concerns a case of a left arteriosclerotic subclavian arterial aneurysm ruptured into esophagus. A 61-year-old man who complained of fever, dyspnea, and dysphagia was diagnosed by chest X-ray, selective left subclavian arteriogram, and chest CT. Because he vomited a large amount of blood before an operation, we suspected that the aneurysm had ruptured into the esophagus, and therefore performed an emergency operation. The operative procedure consisted of exposing the aneurysm through a median sternotomy incision with the addition of a left supraclavicular incision, proximal and distal ligation, and reconstruction of blood flow by an aorto-left subclavian artery bypass with a Gore-tex prosthetic graft; however the aneurysm was not resected because of adhesion to the surrounding tissues. The post-operative course was uneventful and the patient is now normal and back at work, 2 years after the operation. Subclavian arterial aneurysms are relatively rare among peripheral arterial aneurysms. The common causes of subclavian aneurysms are arteriosclerosis (18%), trauma (14.6%), non specific inflammation (13.5%), and thoracic outlet syndrome (11%). Of the only 15 ruptures in 89 cases that have been reported in Japan, none have ruptured into the esophagus. Subclavian artery aneurysms represent a risk of rupture or peripheral circulatory failure, and consequently, should be considered for surgical treatment.
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PMID:[A case of successful repair of a left subclavian arterial aneurysm ruptured into the esophagus--review of 89 cases in Japan]. 267 68

Leiomyoma of the esophagus is not uncommon in the adult population but is rarely seen in children; only 20 cases have been reported in the pediatric population. In this paper we describe two cases of esophageal leiomyoma in female patients aged 6 and 13 years and review previous reports. Several differences were noted between the pediatric and adult population. The mean age in children is 14 years (range, 4 to 20 years). Leiomyoma appears 1.71 times more often in females than in males. Localized lesions are found in only 9%, whereas the diffuse form predominates in 91%. The entire esophagus may be involved 35% of the time, and encroachment on the cardia or upper stomach occurs in 70%. Leiomyomas associated with familial syndromes (familial leiomyoma and Alport's syndrome) occur in 22% of the cases. Major symptoms include dysphagia (86%), dyspnea (36%), vomiting (27%), retrosternal pain (27%), and coughing (22%). The initial diagnosis following contrast studies is most often achalasia. The diagnosis of leiomyoma is made only with subsequent endoscopy. Enucleation was performed in only 11% of the cases; surgical resection (including part of the stomach) was necessary in 78% with a 21% postoperative mortality. Esophageal leiomyoma should be considered in the differential diagnosis of mediastinal masses and esophageal obstruction. Accurate preoperative diagnosis is desirable in order to plan proper surgical treatment.
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PMID:Esophageal leiomyoma in children: two case reports and review of the literature. 268 58

A 32-year-old man had a giant cervical mass, dysphagia, dyspnea, and severe hypercalcemia. A computed tomographic scan showed the mass to extend from the left mandible to the level of the aortic arch. Exploratory surgery of the neck revealed a ruptured parathyroid cyst complicated by massive hemorrhage into the cervical tissues and mediastinum. The postoperative course was uncomplicated with prompt resolution of the hypercalcemia. Although a rare occurrence, extracapsular parathyroid hemorrhage should be considered in the differential diagnosis of all rapidly evolving cervical and mediastinal masses, especially when hypercalcemia is present.
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PMID:Massive extracapsular hemorrhage from a parathyroid cyst. 268 95

Nutritional assistance was indicated in 31 patients with an ENT tumour at different stages of treatment and different stages of the disease. These patients presented with disorders of deglutition with false passages (68%), aspiration pneumonia (10%), dysphagia (35%) or denutrition (17%). We used an endoscopic percutaneous gastrotomy kit produced by the Bioser company (pull technique). In 29 patients, the tube was inserted under general anaesthesia in the operating theatre to prevent dyspnoea during introduction of the tube in these patients with alteration of the airway-gastrointestinal tract junction or because the tube was inserted at the beginning of anaesthesia for ENT surgery. The tube was able to be inserted in every case, with cardiac arrest in one patient who was effectively resuscitated without sequelae, two obstructions of the cuff requiring advancement of the tube with a bougie, 2 ruptures of the thread and one case of dyspnoea. Two patients subsequently developed a wound abscess which was drained and one patient required removal of the tube. Follow-up of the patients demonstrated the good tolerance of this tube which was maintained for an average of 2.9 +/- 0.5 months (0.1 to 9 months) without any major complications. 3 benign wound infections, 4 inflammatory reactions, 4 minimal leaks, 1 case of hyperthermia, 12 cases of abdominal distension and 2 cases of displacement of the tube were observed. The weight gain was equal to 4%. The authors believe that this technique of endoscopic gastrostomy should be preferred to surgical gastrostomy.
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PMID:[Percutaneous endoscopic gastrostomy. Indications and results in 31 patients]. 271 44


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