Hassan Mohamed Omar, Aden Ahmed Shafie, Dahir Osman Farah, Abdi Ahmed Elmi, Abdi Ishak Ahmed, Ahmed Said Abdirahman, Hilowle Nasra Mohamud, Jeele Mohamed Osman Omar
Cardiology Department, Mogadishu Somali Türkiye Training and Research Hospital, Mogadishu, Somalia.
Anesthesia and Reanimation Department, Mogadishu Somali Türkiye Training and Research Hospital, Mogadishu, Somalia.
Int Med Case Rep J. 2025 May 20;18:595-599. doi: 10.2147/IMCRJ.S506415. eCollection 2025.
Dysphagia aortica is an uncommon condition caused by esophageal compression from vascular malformations, often complicating the clinical course in the elderly. This case explores the management of dysphagia aortica in a 90-year-old Somali woman, emphasizing challenges posed by age-related anatomical changes and comorbidities.
The patient presented with chest discomfort, dyspnea, and dysphagia for liquids and solids. Imaging revealed esophageal compression due to ascending aorta dilation. The dysphagia persisted despite pharmacological management, leading to the decision that surgical intervention was too risky. We placed a percutaneous endoscopic gastrostomy (PEG) tube to maintain nutrition, stabilizing her condition and improving her quality of life.
This case underscores the importance of individualized, multidisciplinary management in elderly patients with dysphagia aortica. While PEG is a well-established intervention for severe dysphagia, its application in dysphagia aortica, particularly in frail geriatric patients, highlights a crucial, underrecognized approach. This report adds to the limited literature on dysphagia aortica by demonstrating that non-surgical interventions can be effective in maintaining nutrition and quality of life when surgical risks outweigh potential benefits.
主动脉性吞咽困难是一种由血管畸形压迫食管引起的罕见病症，常使老年患者的临床病程复杂化。本病例探讨了一名90岁索马里女性主动脉性吞咽困难的治疗，强调了与年龄相关的解剖学变化和合并症所带来的挑战。
患者出现胸部不适、呼吸困难以及液体和固体食物吞咽困难。影像学检查显示升主动脉扩张导致食管受压。尽管进行了药物治疗，吞咽困难仍持续存在，因此决定手术干预风险太大。我们放置了经皮内镜下胃造口术（PEG）管以维持营养，稳定了她的病情并改善了她的生活质量。
本病例强调了老年主动脉性吞咽困难患者个体化、多学科管理的重要性。虽然PEG是治疗严重吞咽困难的成熟干预措施，但其在主动脉性吞咽困难中的应用，尤其是在体弱的老年患者中，凸显了一种关键但未得到充分认识的方法。本报告通过证明当手术风险超过潜在益处时，非手术干预在维持营养和生活质量方面可能有效，补充了关于主动脉性吞咽困难的有限文献。
