Dysphagia aortica

Summary A tortuous thoracic aorta is common in the elderly, often displacing the esophagus without causing organic obstruction. The potential for this complication is present, and a case is reported which required surgical relief of this problem.     

Dysphagia aortica: A neglected symptom of aortoesophageal fistula

Aortoesophageal fistula, secondary to thoracic aortic aneurysm, is an uncommon cause of gastrointestinal bleeding that is uniformly fatal without surgical intervention. Typical symptoms are midthoracic pain and/or dysphagia followed by a usually short, albeit unpredictable, symptom-free interval and by a 'herald' haemorrhage, which is observed in 80% of patients before fatal exsanguinations. Dysphagia is present in 45% of patients, sometimes for several weeks, before the first bleeding occurs. However, dysphagia aortica is rarely considered in the differential diagnosis of dysphagia and lack of awareness, as well as symptom's underevaluation, both contribute to a significant diagnostic and therapeutic delay. We present a case of a 77-year-old woman who died for a bleeding AEF consequent to a thoracic aortic aneurysm and whose main symptom during the past 2 months was dysphagia, which was not taken seriously into consideration by her general practitioner. This case report emphasises that primary care physicians should be alerted to evaluate carefully the alarming symptoms like dysphagia -- especially in elderly patients -- before life threatening complications occur, as they are the ones who could suspect early the diagnosis and make a proper referral.     

A neglected symptom of contained aortic laceration—Dysphagia aortica successfully treated by endovascular stentgrafting

Purpose : Dysphagia aortica describes an esophageal swallowing disorder caused by external compression from an ectatic, tortuous, or aneurysmal thoracic aorta. Although well recognized among specialists, dysphagia aortica is rarely considered in the differential diagnosis of dysphagia. Case Report : We present the case of a 75‐year‐old woman with a history of swallowing difficulty and retrosternal pressure sensation. Her symptoms had been attributed to sliding axial hernia along with gastroesophageal reflux disease for the last 12 months. Diagnostic workup at our institution revealed a giant penetrating ulcer of the descending aorta as a culprit of esophageal compression. Expeditious endovascular stentgraft exclusion of the aneurysm was performed because of its symptomatic nature and high propensity of spontaneous rupture. On a recent consultation 2 years after the endovascular procedure, the patient confirmed a complete remission of impaired swallowing and freedom from thoracic discomfort. Conclusions : Dysphagia aortica should be considered in the numerous differential diagnoses of esophageal swallowing disorders in the elderly, as delayed identification may harbor catastrophic outcome for affected individuals. © 2011 Wiley Periodicals, Inc.     

Dysphagia

Opinion statement Dysphagia is a common complaint that always warrants investigation. The patient’s history and preliminary testing can help differentiate between the two types of dysphagia: oropharyngeal or esophageal. Specific treatments for either of these types of dysphagia depend on the underlying etiology. Oropharyngeal dysphagia is often associated with a neuromuscular disorder and is treated with swallowing rehabilitation. Esophageal dysphagia is usually due to an anatomic defect or a motility disorder. Anatomic defects can often be corrected with endoscopic or surgical procedures. Motility disorders often benefit from pharmacologic treatment. Achalasia may be corrected with an endoscopic procedure with pneumatic dilation or, more recently, with injection of botulinum toxin.     

吞咽困难

1引言 吞咽困难(dysphagia)是个希腊词,其意思是进食功能紊乱.典型的吞咽困难指吞咽过程中断造成的进食困难.由于有引起吸人性肺炎、营养不良、脱水、体质量下降和气道阻塞等危险,吞咽困难对人的健康是一种严重威胁.在神经系统和非神经系统疾病患者中,多种病因可引起吞咽困难.     

吞咽困难

吞咽困难包括产生吞咽动作困难(口咽部吞咽困难)和食物或液体在到达胃的过程中的一种被阻滞感(食管吞咽困难)。所以，吞咽困难是指对吞咽物正常通过的一种阻碍。     

Neuroleptic-Induced Dysphagia

Neuroleptic medications may result in extrapyramidal symptoms that can affect swallowing. Both oral and pharyngeal phases of swallowing may be affected. Unlike the more common causes of dysphagia, especially in the elderly, drug-induced dysphagia may be reversible. This report describes a case of neuroleptic-induced dysphagia in an elderly male with Alzheimer's disease. When the loxapine was discontinued, the dysphagia improved significantly.