Dysphagia due to Physiological Constriction after Stroke: A Case Report
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The aortic arch normally causes no symptomatic physiological constriction of the esophagus. Symptoms of dysphagia are generally observed in the presence of specific conditions, such as an aortic aneurysm. In the present case, during a videofluoroscopic swallowing study (VFSS), the authors incidentally found that despite the absence of an aortic lesion, the dysphagia observed in a stroke patient was caused by compression from the aortic arch. The patient complained of discomfort when swallowing, similar to a bolus lodged in the chest, which was consistent with compression by the aortic arch found on the VFSS and chest computed tomography (CT). After undergoing dysphagia therapy, the VFSS after 52 days revealed improved swallowing function; however, the sensation of food lodging in the chest due to compression by the aortic arch persisted. We conclude that although the physiological constriction of the esophagus by the aortic arch is usually asymptomatic, the constriction can be a factor that exacerbates the swallowing function in patients with dysphagia, and should therefore be considered during the differential diagnosis.
Abstract
The aortic arch normally causes no symptomatic physiological constriction of the esophagus. Symptoms of dysphagia are generally observed in the presence of specific conditions, such as an aortic aneurysm. In the present case, during a videofluoroscopic swallowing study (VFSS), the authors incidentally found that despite the absence of an aortic lesion, the dysphagia observed in a stroke patient was caused by compression from the aortic arch. The patient complained of discomfort when swallowing, similar to a bolus lodged in the chest, which was consistent with compression by the aortic arch found on the VFSS and chest computed tomography (CT). After undergoing dysphagia therapy, the VFSS after 52 days revealed improved swallowing function; however, the sensation of food lodging in the chest due to compression by the aortic arch persisted. We conclude that although the physiological constriction of the esophagus by the aortic arch is usually asymptomatic, the constriction can be a factor that exacerbates the swallowing function in patients with dysphagia, and should therefore be considered during the differential diagnosis.
참고문헌 (13)
- Taylor CW, "Dysphagia and thoracoabdominal aneurysm", Postgrad Med J, 77, pp.257~258 (2001)
- Wilkinson JM, "Diagnostic dilemmas in dysphagia aortica", Eur J Cardiothorac Surg, 11, pp.222~227 (1997)
- Ponce J, "Dysphagia of vascular origin", Rev Esp Enferm Dig, 80, pp.53~56 (1991)
- Richter JE, "Esophageal manometry in 95 healthy adult volunteers", Dig Dis Sci, 32, pp.583~592 (1987)
- Pape R, "Uber einen abnormen verlauf(‘tiefe Rechtslage’)der mesa aotitischen aorta descendens", Fortschr Roetgenstr, 46, pp.257~269 (1932)
- Aziz Q, "Modulation of esophageal responses to magnetic stimulation of the human brain by swallowing and by vagal stimulation", Gastroenterology, 109, pp.1437~1445 (1995)
- Diamant NE, "A glimpse at the central mechanism for swallowing", Gastroenterology, 109, pp.1700~1702 (1995)
- Chan YH, "Nonaneurysmatic dysphagia aortica in the elderly : three case reports and literature review", Int J Gerontol, 10, pp.52~55 (2016)
- Mittal RK, "Dysphagia aortica : clinical, radiological, and manometric findings", Dig Dis Sci, 31, pp.379~384 (1986)
- Maurer AH, "Esophageal transit and gastric emptying", J Nucl Med, 44, pp.1~11 (2015)
- Song SW, "A case of dysphagia aortica in an elderly patient", Int J Gerontol, 6, pp.46~48 (2012)
- Hilliard AA, "Dysphagia aortica", Ann Intern Med, 142, pp.230~231 (2005)
- 김정호, "A Patient With Dysphagia due to an Aortic Aneurysm", Korean Circulation Journal, 39(6), pp.258~260 (2009), 대한심장학회