A rare differential diagnosis of dysphagia

Introduction:

Dysphagia can occur in all life decades. Exsiccosis, malnutrition or even aspiration pneumonia are possible consequences of dysphagia. The reasons of a disturbed swallowing act are very diverse: tumors of the upper gastrointestinal tract, congenital malformations, posttraumatic causes or even neurodegenerative diseases.

Case-report:

A 53-year-old man was presenting in November 2018 with 4 weeks of progressive sore throat. Furthermore, the patient complained of dyspnoea while lying down as well as exertional dyspnea. The patient also described dysphagia with suspected aspiration. B symptoms were negated. The presentation in our department was made on suspicion of a retropharyngeal abscess.

The laryngoscopy showed a protrusion of the hypopharyngeal posterior wall with a shift in the glottic area. Overall oropharyngeal and hypopharyngeal mucosa was normal. For further diagnostics, there were laboratory tests, a CT scan and a MRI scan of the head and neck.

Results:

In summary of the medical history, the clinical and radiological results, there was a suspicion of prosthetic loosening (C4/5 and C5/6) with abscess formation after cervical spine surgery in 2011 because of absolute spinal stenosis. There was a revision surgery for ventral stabilization of the spine and material removal.

Conclusion:

This case-presentation should draw attention to a rare differential diagnosis of dysphagia. In addition to various tumors of the head and neck area or even neurological conditions, pathological processes in the cervical spine can cause swallowing difficulties with aspiration and dyspnea

Publication History

Publication Date:
23 April 2019 (online)