Mitropoulos Alexander, Pianko Stephen, Ptasznik Ronnie, Fraser Jacqueline
Internal Medicine, Monash Medical Centre, Clayton, AUS.
Gastroenterology, Monash Health, Melbourne, AUS.
Cureus. 2024 Apr 10;16(4):e57999. doi: 10.7759/cureus.57999. eCollection 2024 Apr.
In this case, a 76-year-old female presenting with globus sensation post-oral intake demonstrated radiographical evidence of mottled radiolucency and prevertebral widening on a lateral neck X-ray at the inferior C4/cricoid cartilage, leading to concern for a prevertebral abscess. A decision was made to proceed with an urgent gastrointestinal endoscopy, and a food bolus was identified and removed, leading to a full remission of the patients' symptoms. In this case, an appropriate diagnosis was achieved by combining multiple investigations, which highlights to clinicians that taking investigations in isolation, with the aforementioned lateral neck X-ray being the primary example, could lead to potential misdiagnosis and mismanagement of patients.
在该病例中,一名76岁女性在进食后出现咽部异物感,颈部侧位X线片显示C4椎体下缘/环状软骨水平有斑点状透光影及椎体前缘增宽,提示可能存在椎前脓肿。于是决定紧急进行胃肠内镜检查,发现并取出了食物团块,患者症状完全缓解。在此病例中,通过综合多项检查做出了正确诊断,这向临床医生强调,孤立地进行检查,如上述以颈部侧位X线片为例,可能会导致对患者的潜在误诊和不当处理。