A Case of Dysphagia Aortica in an Elderly Patient

Song, Sang‐Wook; Chung, Jin-Woong; Kim, Se‐Hong

doi:10.1016/j.ijge.2011.09.030

Cited by 8 publications

(7 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Surgical correction may be performed via transposition of the distal esophagus, esophagomyotomy with division of the right crus of the diaphragm, or aortic resection and repair. Patients may even undergo PEG placement, esophageal dilations or even esophageal stenting for palliative measures (7,8).…”

Section: Discussionmentioning

confidence: 99%

Dysphagia in the aging cardiovascular patient

Mouawad¹,

Ahluwalia²

2017

J. Thorac. Dis.

View full text Add to dashboard Cite

Dysphagia is not a normal process of aging. Dysphagia aortica refers to external compression of the distal esophagus from an enlarged, ectatic or aneurysmal thoracic aorta leading to mechanical obstruction of the food bolus. It is a rare cause of dysphagia seen in the older population and predisposing risk factors include female gender, short stature, and kyphosis. We selected the case of an octogenarian with a significant cardiovascular history presenting with dysphagia where the diagnosis of dysphagia aortica was delayed but ultimately identified. Although rare, we urge and remind a high index of suspicion for clinicians treating this patient population.

show abstract

Section: Discussionmentioning

confidence: 99%

Dysphagia in the aging cardiovascular patient

Mouawad¹,

Ahluwalia²

2017

J. Thorac. Dis.

View full text Add to dashboard Cite

show abstract

“…As mentioned earlier, there is no gold standard for diagnosis of dysphagia aortica [4]. Barium swallow, chest CT, gasteroduodenoscopy, and HRM can be useful diagnostic tools, but a high suspicion index is necessary for diagnosis [3,5]. If extrinsic compression of the esophagus is seen in the esophagoscopy, a contrast CT scan of thorax may be considered to exclude an abnormal vascular ring [10].…”

Section: Discussionmentioning

confidence: 99%

“…Conservative treatments include diet modification like soft and liquid foods, avoidance of solid and sticky meals, careful chewing, and not lying down after eating or taking medications. In patients with severe symptoms or in those unresponsive to conservative treatment, either a feeding tube or more radical surgery can be considered [3][4]12]. A sub-sternal gastric pull up, with or without esophageal resection, may alleviate dysphagia; however, the procedure carries significant morbidity.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Dysphagia Aortica: A Case Report and Review of Treatment Options

Baboli¹,

Mittal²

2021

OBM Geriatrics

View full text Add to dashboard Cite

A 64-year-old, cachectic man with body mass index (BMI) <19 visited in clinic with the chief complaint of dysphagia for 6 months. He reported a 2-year history of reflux and heartburn, for which he has been taking pantoprazole but reported only 40% relief of reflux symptoms. He reported progressive solid food mid-chest dysphagia. Additional comorbidities included severe pulmonary bronchiectasis and bullous emphysema and a history of treated pulmonary tuberculosis 40 years prior and two previous episodes of spontaneous pneumothorax in the right-sided lung treated with a chest tube. A chest X-ray showed a calcified aorta crossing the midline (Figure 1). A CT scan done for assessment of pneumothorax showed a torturous descending thoracic aorta and a dilated mid-/proximal esophagus. The diameter of the descending aorta was 41 mm, and it crossed the midline. For evaluation of dysphagia, a barium swallow was performed, which showed a narrowing in the mid-esophagus with proximal dilation and lack of peristalsis (Figure 2). Upper gastrointestinal endoscopy showed a dilated esophagus with eccentric extraluminal compression. High-resolution manometry (HRM) showed an absence of peristalsis and a vascular pressure artifact around the mid-esophagus correlating with the external aortic compression (Figure 3). Due to alarming weight loss and a BMI <19, we recommended a feeding jejunostomy to maintain nutrition before scheduling definitive treatment.

show abstract

“…It is more commonly noted in short kyphotic elderly women and appears to have an association with conditions such as hypertension, left ventricular enlargement, and congestive heart failure 2 . In fact, there are several reports of improved dysphagia aortica after management of these medical comorbidities 2 , 3 …”

Section: Discussionmentioning

confidence: 99%

Dysphagia aortica secondary to thoracoabdominal aortic aneurysm resolved after endograft placement

Choi

Yang

Gagnon

2019

Journal of Vascular Surgery Cases, Innovations and Techniques

View full text Add to dashboard Cite

Dysphagia aortica is a rare entity defined as difficulty in swallowing due to external compression by the aorta. Aneurysmal dysphagia aortica successfully treated with thoracic endovascular aortic repair (TEVAR) is exceedingly rare. We report the case of a 74-year-old woman with known thoracoabdominal aneurysm who presented with acute shortness of breath and 3-month history of dysphagia. Computed tomography angiography revealed aneurysmal growth and massive esophageal dilation. She underwent TEVAR and visceral debranching, which led to complete symptom resolution correlated with sac regression. We also present a comprehensive review of the literature with a focus on cases of aneurysmal dysphagia aortica treated with TEVAR.

show abstract

A Case of Dysphagia Aortica in an Elderly Patient

Cited by 8 publications

References 12 publications

Dysphagia in the aging cardiovascular patient

Dysphagia in the aging cardiovascular patient

Dysphagia Aortica: A Case Report and Review of Treatment Options

Dysphagia aortica secondary to thoracoabdominal aortic aneurysm resolved after endograft placement

Contact Info

Product

Resources

About