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 patient is described who suffered from prolapse of the lower oesophageal mucosa in the presence of a Schatzki ring. There was variable dysphagia culminating in total aphagia. The clinical symptoms disappeared without any treatment once the patient had overcome several years of psychological stress. The radiological appearances gave rise to a discussion of the radiological anatomy of the terminal oesophagus with a Schatzki ring since numerous similar appearances illustrated in the literature have been interpreted as axial hiatus hernias. A comparison of manometric and radiological fingings has shown that a hernia did not exist. The advantages and errors inherent in diagnosing hernias with the help of the "three rings", as described by Hafter, are discussed. The mucosal prolapse during the stage of aphagia is demonstrated and compared with cases from the literature showing prolapse at the upper and lower vestibular margins. The mechanism leading to these appearances is discussed.
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PMID:[Invagination of the oesophageal mucosa in the presence of a Schatzki ring (author's transl)]. 15 Oct 7

The lower esophageal ring, or Schatzki's ring, consists of a thin, submucosal, circumferential scar which forms a thin incomplete diaphragm in the lower esophageal lumen. The symptoms may be either episodic aphagia or progressive dysphagia, and the severity of symptoms is related to the diameter of the ring. Between 1970 and 1978, we saw 24 patients with lower esophageal rings and complaints of episodic aphagia or progressive dysphagia. Symptoms of esophagitis were present in 20 of the 24. Twenty were treated surgically by interrupting the rings and repairing the sliding hiatal hernias. Two were treated by dilatation and two received no treatment to the ring. Hiatal hernias have recurred in two patients. In one, there is a recurrent ring and in the other, an acid peptic stricture. The ring has responded to dilatation and the peptic stricture to dilatation and repair of the recurrent hernia. Two patients without symptoms of esophagitis, treated by dilatation, are doing well but the follow-up period is so far too short to draw any conclusion.
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PMID:Symptomatic lower esophageal ring: treatment of 24 patients. 47 13

Prescription of so inoffensive-seeming and common a treatment as mucilaginous laxative may have major (if rare) side effects, such as sudden esophageal obstruction. This usually occurs in old people who do not take enough water with the laxative and who may have minor esophageal pathology such as motility disorders or epibronchic diverticulum. The usually typical symptoms are sudden onset, with retrosternal pain, dysphagia or total aphagia, alimentary vomiting and pseudohypersialorrhea. Diagnosis is always by radiography and endoscopy. Radiography must be performed with gastrografin, due to the risk of bronchoaspiration or esophageal fissure. Endoscopy may demonstrate the mucilagenous mass responsible for the obstruction and in most cases restore patency of the esophagus. This technique should always be attempted, if necessary several times, before resorting to surgery. The authors stress that in patients with a risk of esophageal obstruction, such as old people with esophageal disorders, it is essential to explain clearly to the patient that the laxative must be taken with a sufficient quantity of liquid.
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PMID:[Acute complications caused by a mucilaginous laxative]. 650 64

An unusual case of congenital lower oesophageal diaphragm (web) associated with achalasia is described. An 18-year-old nulliparous girl presented with severe cachexia and aphagia following progressive dysphagia. A barium swallow demonstrated the achalasia, and the oesophageal diaphragm with a central pinhole opening was seen at endoscopy. Parenteral hyperalimentation was required for ten weeks prior to surgery. Circumferential excision of the oesophageal diaphragm in conjunction with Y-V advancement oesophagoplasty gave a good result.
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PMID:Lower oesophageal diaphragm and achalasia in an adult. An unusual association. 652 77

Chronic esophagitis induced by radiation therapy (CRE) for carcinoma of the oropharynx and larynx, and involving an initially normal esophagus, is poorly known, and often confused with a locally recurrent malignancy. By reporting 8 consecutive cases, the aim of this study is to contribute to proving that cervical CRE does indeed exist. Eight men, aged 58 to 76 years, developed complete aphagia (7 cases) or severe dysphagia (1 case), 2 to 56 months (median 8.5 months) after radiation therapy for carcinoma of the laryngopharyngeal area. In 5 patients, the primary tumour and/or chains of cervical lymph nodes were removed before radiation therapy; in the 8 patients, the esophagus was endoscopically free of disease. The total dose of radiation exceeded 60 grays in 6 patients. Although they were initially considered as suffering from a locally recurrent malignancy on a clinical basis, none of the 8 patients had patent signs (either endoscopic or histologic) of recurrence. In each case a severe lesion of the cervical esophagus was documented (stenosis 7 cases, giant ulceration 1 case): the diagnosis of CRE was based on endoscopic, histological, and evolutive criteria. Six patients were treated by prolonged nutritional support (via enteral route, 5 cases; parenteral route, 1 case); endoscopic dilatations were used as a single treatment or in association with nutritional support in 4 cases. Three patients died of CRE-induced regional complications; post mortem examination, performed in 2 cases, confirmed CRE without evidence of locally recurrent malignancy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Chronic radiation-induced esophagitis after treatment of oropharyngolaryngeal cancer: a little-known anatomo-clinical entity]. 665 70

The lower esophageal ring is an unusual clinical disorder of the esophagus and consists of a thin submucosal circumferential scar that forms in the lower esophagus. It is probably an acquired lesion resulting from repeated insults to the lower esophageal mucosa. The symptom of dysphagia results from esophageal obstruction, and the degree of obstruction is directly related to the internal diameter of the ring. Episodic aphagia results from impaction of food at the site of the ring. Since 1970, 88 patients have been seen with either dysphagia or episodic aphagia. Sixty-five with chronic limited reflux were treated primarily by oral dilation. Two of them required an antireflux procedure at a later date because of accentuation of reflux symptoms. Eighteen patients received surgical treatment initially because of severe reflux disease. Treatment consisted of interruption of the ring combined with an antireflux procedure. Five patients received no treatment. Lower esophageal ring may be managed satisfactorily through oral dilation, resulting in relief of dysphagia. If reflux disease is present or is accentuated by dilation and cannot be controlled medically, then the appropriate antireflux procedure should be done.
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PMID:Lower esophageal ring: experiences in treatment of 88 patients. 669 42

The aim of this study was to report results of endoscopic YAG laser therapy in palliative treatment of esophageal and cardial carcinoma. Twenty-eight patients were treated: 9 with adenocarcinoma and 19 with squamous cell carcinoma. Among these patients, 9 had complete aphagia; radiotherapy was contraindicated in 17; in the remaining 2 patients the aim of laser therapy was to achieve sufficient luminal enlargement to allow the endoscopic insertion of a prothesis. Dysphagia improved in 24 cases; destruction of a major portion of the intraluminal tumor was achieved in 17 patients, and incomplete destruction was possible in 9 patients. In one case, the treatment had no effect. Among 22 subjects in maintenance treatment, 13 good results were obtained. Several complications of laser therapy were observed: 2 cases of minor bleeding, 2 cases of esophagitis and 1 perforation of the upper esophagus. The patient died after surgical operation. It is concluded that endoscopic YAG laser therapy for palliative treatment of esophageal and cardial carcinoma is effective, providing rapid improvement of dysphagia. Maintenance treatment is necessary to sustain the improvement. Randomized studies are now needed to compare endoscopic laser therapy with other palliative treatment of malignant tumors of the upper gastrointestinal tract.
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PMID:[Palliative treatment of cancers of the esophagus and cardia with YAG neodymium laser. (Preliminary noncontrolled trial)]. 674 75

Although swallowing difficulties (dysphagia) frequently occur in acute brainstem infarction, physiological studies of dysphagia (videofluoroscopy, manometry) are rarely reported. We present a patient with ipsilateral Horner's syndrome, palatal and laryngeal weakness, aphagia, and ipsilateral face and contralateral extremity pin and temperature loss due to lateral medullary infarction confined to the rostral dorsolateral medulla (RDM). Videofluoroscopy showed that the patient was unable to initiate a swallow. Manometry showed a markedly reduced peak pharyngeal pressure and weak pharyngeal contractions. Within 20 months, the patient's neurological deficits resolved, videofluoroscopy showed a normal swallow, and manometry showed normal peak pharyngeal pressure. Correlation of the clinical, physiological, and imaging evaluations shows that aphagia and severe bilateral pharyngeal paresis can result from unilateral RDM infarction. We suggest that, in man, the bilateral medullary swallowing centers function as one integrated center, and that infarction of a portion of this center is sufficient to cause complete loss of swallowing.
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PMID:Aphagia due to pharyngeal constrictor paresis from acute lateral medullary infarction. 956 69

Esophageal compression by a vascular structure is a rare cause of dysphagia, the aberrant right subclavian artery being the most common congenital abnormality. Aortica dysphagia is usually observed in the elderly, especially in hypertensive women with cardiopathy and degenerative osteopathy. We report a 73-year-old woman with dysphagia, caused by a non-aneurysmatic aortic elongation, who presented progressive dysphagia, which ended in aphagia associated with heart failure. The diagnostic approach to these patients is discussed. The patient received cinitapride and, following treatment for heart failure, remains asymptomatic after a 3-year follow-up period, although manometric alterations persist.
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PMID:[Non-aneurysmatic aortic dysphagia]. 1053 7

Dysphagia with anterior osteophytosis of the cervical bone is a more and more reported affection, especially after the age of 60. However it remains a rare event. The cause to effect relationship between these two entities should be documented by a complete assessment. Surgical treatment is reserved for patients whose medical treatment has failed. We describe an original case of cervical bone osteophytosis which was diagnosed during an acute and febrile aphagia and review the literature about its assessment and treatment.
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PMID:[Dysphagia and cervical osteophytosis: case report and review of the literature]. 1190 42


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