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

An unusual case of foreign body in the oesophagus is reported. A history of dysphagia was absent although oesophageal obstruction was total; the retained foreign body was vegetable matter. An unusual radiological appearance, "the inverted wine-glass sign" is described. Pure water depletion was diagnosed there being dehydration combined with hypernatraemia (Na = 164MEq/L), normokalaemia (K+ = 4.2mEq/L), and acidosis (Serum bicarbonate = 10 mEq/L), as well as uraemia (220 mg%), and haemoconcentration (haemoglobin=18.5g%). Treatment with oesophageal lavage and intravenous fluids was successful.
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PMID:An unexpected foreign body in the oesophogus: a case report. 75 6

Detailed viscosity measurements have been made of barium sulfate mixtures over a wide range of viscosities for use in radiography of the esophagus, stomach, and duodenum. A new methodology was developed for more accurate estimation of viscosity in non-Newtonian fluids in conventional cylinder-type viscometers. As base cases, the variation of viscosity with shear rate was measured for standard commercial mixes of e.z.hd (250% w/v) and a diluted mixture of liquid e.z.paque (40% w/v). These suspensions are strongly shear thinning at low shear rates. Above about 3s-1 the viscosity is nearly constant, but relatively low. To increase the viscosity of the barium sulfate mixture, Knott's strawberry syrup was mixed to different proportions with e.z.hd powder. In this way viscosity was systematically increased to values 130,000 times that of water. For these mixtures the variation of viscosity with temperature, and the change in mixture density with powder-syrup ratio are documented. From least-square fits through the data, simple mathematical formulas are derived for approximate calculation of viscosity as a function of mixture ratio and temperature. These empirical formulas should be useful in the design of "test kits" for systematic study for pharyngeal and esophageal motility, and clinical analysis of motility disorders as they relate to bolus consistency.
Dysphagia 1992
PMID:Viscosity measurements of barium sulfate mixtures for use in motility studies of the pharynx and esophagus. 142 24

Sixteen patients (nine male) underwent perendoscopic pneumatic dilatation for achalasia. The Witzel dilator was chosen as it allows placement of the balloon under endoscopic vision. Its efficacy was assessed using esophageal scintigraphy. Symptom score and esophageal transit values at 100 s and after a drink of water all improved significantly (P less than or equal to 0.014) after dilatation and there was a significant correlation between the improved symptom score and the change in transit values after 100 s (r = 0.586, P = 0.017). At follow-up at 8 (3-16) months [mean (range)], 15 of 16 patients (94%) are symptom free. The Witzel dilator is effective in the treatment of achalasia. Esophageal scintigraphy offers a quantitative assessment of esophageal function, helping the clinical investigator evaluate new forms of therapy.
Dysphagia 1992
PMID:Perendoscopic pneumatic dilatation in achalasia: assessment of outcome using esophageal scintigraphy. 142 32

Foreign body entrapment and mucosal injury caused by oral medications are increasingly reported to occur in the upper esophagus in apparently normal subjects. We performed esophageal manometry in 40 normal volunteers to determine whether a unique motility pattern in the upper third of the esophagus predisposes to entrapment of foreign bodies at this site; 18 normal volunteers also had transit scintigraphy of a gelatin capsule filled with a radionuclide. The esophageal body was divided into five consecutive segments starting proximally, with each segment corresponding to 20% of the total length. Amplitude, slope, and velocity of the esophageal contraction were markedly decreased in the second segment compared with the other segments. Entrapment and dissolution of a gelatin capsule occurred in 39% of volunteers in the proximal esophagus correlating to the second segment, i.e., the segment with the lowest amplitude, slope, and velocity of esophageal contractions. The observation that wet swallows have greater amplitudes (P less than 0.01) and steeper slopes (P less than 0.05) than dry swallows explains why the occurrence of pill entrapment was reduced when taken with sufficient water. However, even with a water chaser of 120 mL, pill entrapment occurred at the second segment of the esophagus in 1 of 18 volunteers. The observed motility pattern in the proximal esophagus provides a better explanation for the entrapment of foreign bodies at this site than compression of the esophagus by the left main stem bronchus, aortic arch, or left atrium as suggested by other investigators.
Dysphagia 1992
PMID:Foreign body entrapment in the esophagus of healthy subjects--a manometric and scintigraphic study. 142 35

Manometric studies using water boluses do not always demonstrate disturbances in esophageal motility. We tested the use of a marshmallow bolus to induce abnormal manometric patterns in patients with dysphagia in whom manometric studies using water boluses were normal or nearly so. The study group included 12 normal volunteers and 22 patients with dysphagia and nearly normal manometric studies. Pressure was recorded along the esophageal body using 10 "wet" swallows followed by 10 "solid" swallows of marshmallow. In normal subjects there were fewer abnormal contractions after solid swallows than after wet swallows. In 15 patients solid swallows induced abnormal motility patterns which were not observed after wet swallows. The probability of inducing abnormal contractions in patients after solid swallows is significantly greater than after wet swallows (p < 0.0001). Solid swallowing is therefore useful in evaluating functional disturbances of the esophagus in patients with dysphagia.
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PMID:[Marshmallow for investigating functional disturbances of the esophageal body]. 142 73

A 3-oz water swallow test identified 80% (16/20) of patients aspirating during a subsequent videofluoroscopic modified barium swallow examination (sensitivity, 76%; specificity, 59%). It also identified patients with more severe dysphagia aspirating larger amounts (sensitivity, 94%; specificity, 26%) or thicker consistencies (sensitivity, 94%; specificity, 30%) of test material. The 3-oz water swallow test is a sensitive screening tool for identifying patients at risk for clinically significant aspiration who need referral for more definitive modified barium swallow evaluation.
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PMID:Validation of the 3-oz water swallow test for aspiration following stroke. 830 34

Between September 1983 and March 1991, 251 consecutive patients with gastro-oesophageal reflux resistant to medical treatment underwent posterior hemifundoplication (modified Toupet procedure). One hundred and seventy-seven patients (71 percent) had peptic oesophagitis. pH monitoring showed a mean Kaye's score of 278 +/- 245 with a 29 percent part of total recording time at pH < 4. The mean low oesophageal sphincter pressure was 8.5 +/- 6.5 cm H2O. No patient died in the postoperative period. Morbidity consisted of 8 splenic injuries, as well as 8 pulmonary and 23 thromboembolic complications. Assessment of 199 patients (79 percent) with a mean follow-up of 32 +/- 21 months showed complete symptomatic relief in 96.5 percent, and complete endoscopic healing of oesophagitis was noted in 96 percent. Restoration of the pH profile to normal levels was obtained in 86 percent of the cases. The mean low oesophageal sphincter pressure had risen to 17 +/- 6 cm H2O. Early postoperative dysphagia was noted in 46 patients (18 percent); one of them required reoperation. Reflux symptoms persisted in 9 patients (4.5 percent). pH monitoring revealed abnormal levels in 3 patients. The results of this study demonstrate that effective gastro-oesophageal reflux control can be achieved with the modified Toupet procedure.
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PMID:[Gastroesophageal reflux treated by posterior hemifundoplication. 251 cases]. 145 66

In 1969, Opitz et al. reported the first case of G Syndrome (Opitz-Frias Syndrome). They presented their clinical observations on 4 brothers from the 'G Family' who shared a constellation of findings with a generalised tendency to midline defects. Major manifestations of this multiple congenital anomaly syndrome include hypertelorism, prominent forehead, cleft lip and palate, narrow palpebral fissures with epicanthal folds, dysphagia, stridor, laryngotracheal oesophageal clefts, and hypospadias. The most significant manifestation of a midline field developmental defect in these infants is aspiration which poses the greatest threat to life. Urgent evaluation should include a water-soluble contrast oesophagram and aerodigestive endoscopy. In addition to repair of the laryngeal cleft, which occurs in approximately 30% of the cases, a tracheostomy, feeding gastrostomy, and Nissen fundoplication are often needed. We report a male infant born with G. syndrome. BBB Syndrome (Opitz Syndrome) is also discussed which bears a striking resemblance to the G Syndrome; in fact, they may be variants of the same allelic syndrome.
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PMID:G syndrome: a review of the literature and a case report. 156 17

It has been shown that food ingestion can provoke esophageal motor abnormalities in patients with otherwise normal manometry. Such motor abnormalities are usually nonspecific in character. We now report water swallow and food ingestion data on 12 patients with a history of dysphagia and/or chest pain who satisfied strict manometric diagnostic requirements for diffuse esophageal spasm. Three of these patients had normal water swallow manometry, yet, during food ingestion, showed manometric evidence of diffuse esophageal spasm. In the other nine patients, the occurrence of nonperistaltic contractions was greater, and there was a greater incidence of nonperistaltic contractions of 100 mm Hg or more after ingestion of food. We conclude that food ingestion increases the diagnostic yield of manometric testing for diffuse esophageal spasm and, not infrequently, magnifies an abnormality seen during standard water-swallow testing.
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PMID:Manometry during food ingestion aids in the diagnosis of diffuse esophageal spasm. 159 42

Twenty-two sheep and 4 goats suffering from central nervous listeriosis were treated with a therapy that had proved to be successful in cattle. For one week they received daily subcutaneous injections of 50,000 IU Procaine Penicillin G per kg live weight and 5 to 10 mg Vitamin B1 per kg body weight. The base excess was tested by blood gas analysis, and it was compensated by intravenous infusion of Na-bicarbonate. Animals that could not eat or swallow received water and rumen liquid by stomach tube. Eight of 26 patients (31%) were healed. The prognosis of central nervous listeriosis depends mainly on the time of initial treatment and on the degree of general disturbances: More than 90% of the animals that were recumbent (16 of 17) or showed dysphagia (12 of 13) at the beginning of treatment died or had to be euthanized because of persistent central nervous disturbances. The correction of blood-pH was of no therapeutic benefit when the disease was already in progress. Treatment of central nervous listeriosis seems to be effective as long as the patients can stand and swallow. When patients received care at this early stage of disease, 77% (7 of 9) were healed and returned to the flock.
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PMID:[Therapy of central nervous system listeriosis in sheep]. 165 79


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