[Acute dysphagia: often there is a readily treatable cause].
Three patients, one woman aged 45 years and two men aged 40 and 62 years, presented with acute dysphagia due to oesophageal obstruction by a piece of food. In the woman symptoms of oesophageal perforation developed after the piece of food was removed by rigid endoscopy; she recovered after treatment with a stent, antibiotics and acid inhibitors. The younger man had a stricture of the oesophagus that was dilated. The older man had a Barrett's oesophagus and also oesophagcal adenocarcinoma; he was free of symptoms three years after resection of the oesophagus and the creation of a tubular stomach. In adults, 60% of acute oesophageal obstructions are caused by food impaction, which is associated with a high incidence of secondary pathologic findings in the oesophagus (75-97%). Evaluation of the oesophagus by flexible endoscopy contributes to an adequate diagnosis. Moreover, it can be used to treat the cause of the obstruction. If dilation therapy is started early after detecting a benign stricture in the oesophagus, it reduces the likelihood of recurrence. The detection of early-stage oesophageal malignancies may improve the prognosis of patients with this disorder.
Moons
L M
LM
Erasmus Medisch Centrum, locatie Dijkzigt, afd. Maag-, Darm- en Leverziekten, Postbus 2040, 3000 CA Rotterdam. l.m.g.moons@erasmusmc.nl
Kuipers
E J
EJ
Siersema
P D
PD
D000208:Acute Disease; D000230:Adenocarcinoma / Q000150:complications; D000328:Adult; D001471:Barrett Esophagus / Q000150:complications; D003680:Deglutition Disorders / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D004938:Esophageal Neoplasms / Q000150:complications; D004939:Esophageal Perforation / Q000150:complications / Q000209:etiology / Q000628:therapy; D004940:Esophageal Stenosis / Q000150:complications; D004945:Esophagoscopy; D004947:Esophagus / Q000473:pathology; D005260:Female; D005502:Food; D005547:Foreign Bodies / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged