Halpert R D, Spickler E, Feczko P J
Radiology. 1985 Mar;154(3):589-91. doi: 10.1148/radiology.154.3.3969457.
Five patients presented with dysphagia but did not have abnormal esophageal motility or morphology on the esophagram. Each was found to have a malignant gastric tumor which did not appear to involve the gastroesophageal junction, and this was confirmed surgically in 2 cases. In 2 patients, diagnosis was delayed as a result of failure to examine the stomach following a normal esophagram. In the absence of abnormal esophageal motility, changes involving the gastroesophageal junction, or cerebral metastases, it is postulated that the dysphagia represented a nonspecific regional response to functional obstruction of the upper gastrointestinal tract secondary to an infiltrating neoplasm of the stomach. The fact that the esophagram was normal emphasizes the possibility that gastric lesions in patients with dysphagia may be missed when only a routine esophagram is employed. The authors recommend that the stomach be examined when no apparent cause for dysphagia can be discerned above the gastroesophageal junction.
5例患者出现吞咽困难，但食管造影显示食管动力和形态均无异常。每例患者均发现患有恶性胃肿瘤，似乎未累及胃食管交界部，其中2例经手术证实。2例患者因食管造影正常后未检查胃部而导致诊断延迟。在没有食管动力异常、胃食管交界部改变或脑转移的情况下，推测吞咽困难代表了胃浸润性肿瘤继发上消化道功能性梗阻的一种非特异性局部反应。食管造影正常这一事实强调了仅采用常规食管造影时，吞咽困难患者的胃部病变可能被漏诊的可能性。作者建议，当在胃食管交界部上方未发现明显的吞咽困难原因时，应对胃部进行检查。
