Shahvaran Seyed Alireza, Kliment Martin, Prax Stefan, Paul Tobias, Heese Oliver, Schmitz Daniel
Department of Gastroenterology and Infectiology, Helios Kliniken Schwerin, University Campus of Medical School Hamburg, Schwerin, Germany.
Medical School Hamburg, Hamburg, Germany.
Z Gastroenterol. 2024 Dec;62(12):2061-2064. doi: 10.1055/a-2367-8409. Epub 2024 Sep 25.
Dysphagia is a common symptom in patients presenting to the gastroenterologist. However, extraluminal causes of dysphagia may be missed by endoluminal diagnosis alone. This case report presents a 72-year-old man with slowly progressive dysphagia that occurred with the ingestion of certain solid foods and was intermittently associated with severe aspiration. Esophagogastroduodenoscopy and barium swallow study were both normal. However, a conventional x-ray and computed tomography (CT) scan of the neck revealed diffuse idiopathic skeletal hyperostosis (Forestier's disease) of the anterior cervical spine (C2-C7). Fiber endoscopic evaluation of swallowing (FEES) revealed functionally incomplete emptying of the oral cavity during swallowing, and the patient reported dysphagia score (EAT-10) was 23 (normal < 3). Surgical removal of the hyperostosis (C3-C6) resulted in immediate and sustained improvement in dysphagia at 3 months.
吞咽困难是就诊于胃肠病学家的患者的常见症状。然而，仅通过腔内诊断可能会漏诊吞咽困难的腔外原因。本病例报告介绍了一名72岁男性，其在摄入某些固体食物时出现缓慢进展的吞咽困难，并间歇性伴有严重误吸。食管胃十二指肠镜检查和钡餐检查均正常。然而，颈部的传统X线和计算机断层扫描（CT）显示颈椎前路（C2 - C7）弥漫性特发性骨肥厚（Forestier病）。纤维内镜吞咽评估（FEES）显示吞咽时口腔功能排空不完全，患者报告的吞咽困难评分（EAT - 10）为23（正常<3）。手术切除骨肥厚（C3 - C6）后3个月，吞咽困难立即且持续改善。
