Dinari G, Danziger Y, Mimouni M, Rosenbach Y, Zahavi I, Grunebaum M
Pediatric Gastroenterology Unit, Beilinson Medical Center, Petah Tiqva, Israel.
J Pediatr Gastroenterol Nutr. 1987 Mar-Apr;6(2):212-6. doi: 10.1097/00005176-198703000-00008.
A 3-year-old child with cricopharyngeal dysfunction is reported. Swallowing difficulties, nasal regurgitation, and gagging developed at 2 months of age. Repeated aspirations and over 40 episodes of pneumonia necessitating multiple hospitalizations occurred up to 2 years of age, along with pharyngeal pooling of saliva and inability to swallow solid food. Barium was held up at the cricopharyngeal level, and a prominent esophageal impression was seen at the same level. Symptoms were completely alleviated after two esophageal dilatations by mercury dilators, and the relief persisted for the 6 months of follow-up. The diagnosis of cricopharyngeal dysfunction is discussed, and the necessity for manometric studies, in the face of often misleading radiologic appearance, is emphasized. It is suggested that early use of esophageal dilatations might prevent prolonged morbidity and afford long-term symptomatic relief.
报告了一名3岁患有环咽肌功能障碍的儿童。该患儿在2个月大时出现吞咽困难、鼻反流和作呕症状。直至2岁时，反复发生误吸及40多次肺炎发作，需要多次住院治疗，同时伴有咽部唾液积聚和无法吞咽固体食物。钡剂在环咽肌水平受阻，且在同一水平可见明显的食管压迹。经用汞扩张器进行两次食管扩张后，症状完全缓解，且在6个月的随访期内症状持续缓解。文中讨论了环咽肌功能障碍的诊断，并强调面对常具误导性的放射学表现时进行测压研究的必要性。建议早期使用食管扩张术可能预防长期发病并带来长期症状缓解。
