A french-fried foreign body.A 42-year-old, otherwise-healthy woman presented to the Center for Voice and Swallowing at the University of California, Davis The University of California, Davis, commonly known as UC Davis, is one of the ten campuses of the University of California, and was established as the University Farm in 1905. , with a 2-year history of dysphagia for solids. Findings on fiberoptic endoscopic evaluation of swallowing with sensory testing (FEESST) were normal with the exception of slightly elevated laryngeal sensory thresholds (6 mm Hg on the left and 7 mm Hg on the right). The results of a dynamic fluoroscopic Fluoroscopic (fluoroscopy) An x-ray procedure that produces immediate images and motion on a screen. The images look like those seen at airport baggage security stations. Mentioned in: Hypotonic Duodenography swallow evaluation were normal except for a slightly prolonged pharyngoesophageal segment (PES) opening time. Pharyngeal and PES manometry manometry /ma·nom·e·try/ (-e-tre) the measurement of pressure by means of a manometer. anal manometry were normal. Transnasal esophagoscopy (TNE) without sedation, which was performed 4 hours after the patient had eaten lunch, detected retained food debris in the distal esophagus--specifically, an unchewed, 5-cm french-fried potato (figure, A). The french fry was gently pushed into the stomach. Evaluation of the esophagogastric junction revealed a small sliding hiatal hernia and Los Angeles Classification grade A erosive esophagitis esophagitis /esoph·a·gi·tis/ (e-sof?ah-ji´tis) inflammation of the esophagus. chronic peptic esophagitis reflux e. (figure, B). Biopsy confirmed short-segment (<3 cm) Barrett's esophagus. [FIGURE OMITTED] With more than 6 million pounds sold annually, french fries account for more than one-fourth of all potato sales in the United States. (1) The patient in this case was instructed to chew her food thoroughly. She was also educated about behavioral modifications for reflux disease and placed on a once-daily proton-pump inhibitor (PPI (1) (Pixels Per Inch) The measurement of the resolution of a monitor or scanner. For example, a monitor that is 16 inches wide and displays 1600 pixels across its width would have a resolution of 100 ppi (1600 divided by 16). ). Her dysphagia gradually resolved over the ensuing 3 weeks. Some 37% of patients with peptic esophagitis will experience dysphagia, and most patients with reflux-induced dysphagia (83 %) will improve after 4 weeks of PPI therapy. (2) Recidivistic dysphagia may indicate failed healing. References (1.) United States Department of Agriculture United States Department of Agriculture (USDA), n.pr established in 1862, USDA is responsible for the safety of meat, poultry, and egg products. It conducts ongoing research in areas from human nutrition to new crop technologies and also helps ensure open , 2002. www.ers.usda.gov. (2.) Vakil NB, Traxler B, Levine D. Dysphagia in patients with erosive esophagitis: Prevalence, severity, and response to proton pump inhibitor proton pump inhibitor n. A class of drugs that inhibit gastric acid secretion by interfering with the movement of hydrogen ions across cell membranes and are used mainly to treat peptic ulcers, gastroesophageal reflux disease, and esophagitis. treatment. Clin Gastroenterol Hepatol 2004;2:665-8. Peter C. Belafsky, MD, PhD From the Center for Voice and Swallowing, Department of Otolaryngology, School of Medicine, University of California, Davis; peterb@ucdvoice.org |
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