Dysphagia
Bohutová J.1, Fencl P.2
Radiodiagnostická klinika IPVZ a 1. LF UK, FN Na Bulovce, Praha1 přednostka prof. MUDr. J. Bohutová, DrSc.Radiodiagnostické oddělení ÚVN, Praha2 primář MUDr. P. Fencl, CSc. |
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Summary:
The swallowing difficultiesmay be caused by various diseases occurring in oral cavity, pharynx and
esophagus up to cardia. The disorder may be functional or anatomical (e.g., of central origin), but
most frequently there is a combination of both factors. The diseases of swallowing passages may be
divided in inborn and acquired, benign and malignant, while even the most benign defect or finding
may result, due to developing consequences (perforation, mediastinitis), in a serious health damage
leading even to fatal consequences. The benign affections include foreign body in the esophagus,
injury of esophagus wall, inflammations, pressure changes (massive osteophytes in cervical section,
expansion processes in the neighborhood, diverticles (including the Zenker one), hypertonia of
cricopharyngeal muscle, achalasia, sideropenic dysphagia, spasms of different type, benign tumors,
etc.
Benign tumors in the swallowing passages are rare, malignant tumors being more frequent and
serious. The squamocellular carcinoma is usually localized in the middle part of esophagus, more
frequently in men over 50 years of age. Adenocarcinoma originates at a younger age, usually from
metaplasia at the border of mucosa of esophagus and stomach. Precancerous states should be
regularly observed.
The diagnostics of diseases of swallowing passages has been subject to considerable development
over the last decades. As for radiological methods, the methods of examination were extended to
include modern procedures (CT, MR). The other methods include mainly endoscopy, sometimes
supplemented with endosonography, manometry, pH metry and scintigraphy.
Key words:
dysphagia – benign and malignant diseases of the pharynx – benign and malignant
diseases of the esophagus – functional disorders – radiology of esophagus
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