Related Experiment Videos
Syringomyelia presenting as cricopharyngeal pseudostricture
M I Malik1, K B Schwarz, S Kotagal
1Department of Pediatrics, St. Louis University Medical Center, Cardinal Glennon Children's Hospital, Missouri.
Journal of Pediatric Gastroenterology and Nutrition
|July 1, 1990
Summary
A neurological condition caused a cervical esophageal stricture in a 14-year-old boy. This case highlights the importance of considering neurological diseases in diagnosing esophageal strictures.
Area of Science:
- Neurology
- Gastroenterology
- Medical Imaging
Background:
- A 14-year-old boy presented with dysphagia and dysphonia, initially diagnosed with a cervical esophageal stricture via upper gastrointestinal radiography.
- Initial neurological examination revealed cranial nerve abnormalities and hyperreflexia, suggesting a cervicomedullary junction lesion.
Observation:
- Despite initial radiographic findings suggestive of a stricture, esophagoscopy and esophageal manometry showed no evidence of obstruction, revealing a low-pressure cervical esophageal sphincter.
- Computed tomography of the head, neck, and spine did not reveal any abnormalities.
Findings:
- Magnetic resonance imaging (MRI) of the brain and spine identified a large syrinx extending from the C2 to T2 segments.
- The patient's symptoms were ultimately attributed to the neurological condition, specifically the syrinx, rather than a structural esophageal abnormality.
Implications:
- This case underscores the necessity of including neurological disorders in the differential diagnosis for apparent cervical esophageal strictures.
- It emphasizes the crucial role of advanced neuroimaging, such as MRI, in diagnosing complex cases where initial investigations are inconclusive.
- Considering neurological etiologies can prevent misdiagnosis and guide appropriate treatment for patients presenting with dysphagia and related symptoms.