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66-year-old man with refractory dysphagia | Frontline Gastroenterology
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No commercial re-use. See rights and permissions. Published by BMJ Group." /> <meta name="DC.AccessRights" content="restricted" /> <meta name="DC.Description" content="A 66-year-old man presented with a 20-year history of progressively worsening dysphagia and intermittent chest pain. The patient described a sensation of food ‘sticking’ in his lower chest which occurred with both solids and liquids, impacting his quality of life significantly. His medical history was otherwise unremarkable with no known allergies, prior surgeries or chronic conditions. During the initial evaluation, a barium swallow was performed. The imaging revealed a notable and unusual spiral-shaped alteration in the morphology of the middle to the lower oesophagus (figure 1). This morphological change was accompanied by a mild irregular narrowing of the oesophageal lumen (figure 2). 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Farré;citation_title=Botulinum toxin reduces Dysphagia in patients with nonachalasia primary esophageal motility disorders;citation_pages=1115-21;citation_volume=11;citation_year=2013;citation_pmid=23591282;citation_doi=10.1016/j.cgh.2013.03.021" /> <meta name="citation_reference" content="citation_journal_title=Neurogastroenterol Motil;citation_title=Jackhammer esophagus: Clinical presentation, manometric diagnosis, and therapeutic results-Results from a multicenter French cohort;citation_volume=32;citation_year=2020" /> <meta name="twitter:title" content="66-year-old man with refractory dysphagia" /> <meta name="twitter:card" content="summary_large_image" /> <meta name="twitter:image" content="https://fg.bmj.com/sites/default/files/highwire/flgastro/16/2.cover-source.jpg" /> <meta name="twitter:description" content="A 66-year-old man presented with a 20-year history of progressively worsening dysphagia and intermittent chest pain. The patient described a sensation of food ‘sticking’ in his lower chest which occurred with both solids and liquids, impacting his quality of life significantly. His medical history was otherwise unremarkable with no known allergies, prior surgeries or chronic conditions. During the initial evaluation, a barium swallow was performed. The imaging revealed a notable and unusual spiral-shaped alteration in the morphology of the middle to the lower oesophagus (figure 1). This morphological change was accompanied by a mild irregular narrowing of the oesophageal lumen (figure 2). Despite this irregular narrowing, a subsequent endoscopic examination of the oesophagus revealed no signs of mucosal damage or lesions effectively ruling out the presence of oesophageal cancer. Given …" /> <meta name="og-title" property="og:title" content="66-year-old man with refractory dysphagia" /> <meta name="og-url" property="og:url" content="https://fg.bmj.com/content/16/2/177" /> <meta name="og-site-name" property="og:site_name" content="Frontline Gastroenterology" /> <meta name="og-description" property="og:description" content="A 66-year-old man presented with a 20-year history of progressively worsening dysphagia and intermittent chest pain. The patient described a sensation of food ‘sticking’ in his lower chest which occurred with both solids and liquids, impacting his quality of life significantly. His medical history was otherwise unremarkable with no known allergies, prior surgeries or chronic conditions. During the initial evaluation, a barium swallow was performed. The imaging revealed a notable and unusual spiral-shaped alteration in the morphology of the middle to the lower oesophagus (figure 1). This morphological change was accompanied by a mild irregular narrowing of the oesophageal lumen (figure 2). Despite this irregular narrowing, a subsequent endoscopic examination of the oesophagus revealed no signs of mucosal damage or lesions effectively ruling out the presence of oesophageal cancer. Given …" /> <meta name="og-type" property="og:type" content="article" /> <meta name="og-image" property="og:image" content="https://fg.bmj.com/sites/default/files/highwire/flgastro/16/2.cover-source.jpg" /> <link rel="alternate" type="application/vnd.ms-powerpoint" title="Powerpoint" href="/content/16/2/177.ppt" /> <title>66-year-old man with refractory dysphagia | Frontline Gastroenterology</title> <link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__j3bc5de1DpXKe0LzZy8ng1oxDGszOUzR0Ax6hYX7dJ8__tKfsVWYeHAohFKsGu4Am_dBfCWp6m81lkUNvtCD12-8__qcfEmPct4iRD6U8DZvqe4X4oudszWFGA0SR50Zgvtsc.css" media="all" /> <!-- OneTrust Cookies Consent Notice start --> <script src="https://cookie-cdn.cookiepro.com/scripttemplates/otSDKStub.js" type="text/javascript" charset="UTF-8" data-domain-script="565e50dd-f6e9-46d6-91cd-5c40a270264f"></script> <script type="text/javascript"> function OnetrustAdsConsent(){ if(googletag.apiReady){ //console.log("GoogleTag API ready") 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class="field-items"><div class="field-item even">Neurogastroenterology</div></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-entity-field pane-node-field-highwire-a-series-title article-series-title col-narrow-10" > <div class="pane-content"> <div class="field field-name-field-highwire-a-series-title field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even">Inside view</div></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-article-citation col-mobile-10 col-narrow-10 col-normal-11 article-title" > <div class="pane-content"> <div class="highwire-article-citation highwire-citation-type-highwire-article node147280" data-node-nid="147280" id="node-147280--2346324800" data-pisa="flgastro;16/2/177" data-pisa-master="flgastro;flgastro-2024-102831" data-apath="/flgastro/16/2/177.atom"><cite class="highwire-cite highwire-cite-highwire-article highwire-citation-bmjj-title clearfix"> <div class="highwire-cite-title">66-year-old man with refractory dysphagia</div> <span class="highwire-cite-access"><span class="highwire-citation-access highwire-citation-access-check" data-pisa-id="flgastro;flgastro-2024-102831" data-atom-uri="/flgastro/16/2/177.atom" data-request-view="full"></span></span> </cite> </div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-panel-tabs-container col-narrow-12 clear" > <div class="pane-content"> <div data-panels-ajax-tab-preloaded="jnl_template_bmjj_tab_art" id="panels-ajax-tab-container-highwire_article_tabs" class="panels-ajax-tab-container"><div class="panels-ajax-tab-loading" style ="display:none"><img class="loading" src="https://fg.bmj.com/sites/all/modules/contrib/panels_ajax_tab/images/loading.gif" alt="Loading" title="Loading" /></div><div class="panels-ajax-tab-wrap-jnl_template_bmjj_tab_art"><div class="panel-display panel-1col clearfix" > <div 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class="xref-aff"></span>, </li><li class="last" id="contrib-5"><a href="http://orcid.org/0000-0001-9430-9874" class="bmjj-markup-orcid-logo" target="_blank">http://orcid.org/0000-0001-9430-9874</a><span class="name">Dong Wu</span><span class="xref-aff"></span></li></ol><ol class="affiliation-list"><li class="aff"><address> <span class="institution">Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College</span>, <span class="institution">Peking Union Medical College Hospital</span>, <span class="addr-line">Beijing</span>, China </address></li></ol><ol class="corresp-list"><li class="corresp" id="corresp-1"><span class="corresp-label">Correspondence to</span> Dr Xiaoqing Li; <span class="em-link"><span class="em-addr">lixq{at}pumch.cn</span></span> </li></ol></div></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-markup abstract-with-bc" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" id="content-block" xmlns:xhtml="http://www.w3.org/1999/xhtml"><span class="related-urls"></span></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-custom pane-1" > <div class="pane-content"> <p><a href="https://doi.org/10.1136/flgastro-2024-102831" target="_new">https://doi.org/10.1136/flgastro-2024-102831</a></p> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-altmetrics" > <h2 class="pane-title">Statistics from Altmetric.com</h2> <div class="pane-content"> <div data-badge-details="right" data-badge-type="medium-donut" data-doi="10.1136/flgastro-2024-102831" data-hide-no-mentions="true" class="altmetric-embed"></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-bmjj-jumplinks" > <div class="pane-content"> <div class="highwire-list-wrapper"><div 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You will be able to get a quick price and instant permission to reuse the content in many different ways.</p> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-panels-ajax-pane-content permissions-box pane-highwire-permission-link" id="request-permissions"> <h2 class="pane-title"><span class='panels-ajax-pane-title' data-pid='new-70fd4c70-563e-4b94-ae3b-2a97f3980c13'></span></h2> <div class="pane-content"> <div class='panels-ajax-pane panels-ajax-pane-new-70fd4c70-563e-4b94-ae3b-2a97f3980c13' data-pid='new-70fd4c70-563e-4b94-ae3b-2a97f3980c13'></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-markup" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article extract-view"><span class="highwire-journal-article-marker-start"></span><ul class="kwd-group"><li class="kwd"><a href="/keyword/oesophageal-motility-disorder" class="hw-term hw-article-keyword hw-article-keyword-oesophageal-motility-disorder" rel="nofollow">OESOPHAGEAL MOTILITY DISORDER</a></li></ul><div class="section" id="sec-1"><h2 class="">Clinical presentation</h2><p id="p-1">A 66-year-old man presented with a 20-year history of progressively worsening dysphagia and intermittent chest pain. The patient described a sensation of food ‘sticking’ in his lower chest which occurred with both solids and liquids, impacting his quality of life significantly. His medical history was otherwise unremarkable with no known allergies, prior surgeries or chronic conditions. During the initial evaluation, a barium swallow was performed. The imaging revealed a notable and unusual spiral-shaped alteration in the morphology of the middle to the lower oesophagus (figure 1). This morphological change was accompanied by a mild irregular narrowing of the oesophageal lumen (figure 2). Despite this irregular narrowing, a subsequent endoscopic examination of the oesophagus revealed no signs of mucosal damage or lesions effectively ruling out the presence of oesophageal cancer. Given … </p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="https://fg.bmj.com/content/16/2/177.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-markup footnotes" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section fn-group" id="fn-group-1"><h2>Footnotes</h2><ul><li class="fn-other" id="fn-1"><p id="p-8"><span class="fn-label">Contributors</span> XB: Conceptualisation, Methodology, Original Draft Preparation, Review and Editing. XL: Data Curation, Formal Analysis, Visualisation, Review and Editing. ZW: Data Curation, Formal Analysis. XW: Data Curation, Formal Analysis. DW: Investigation, Resources, Supervision, Project Administration, Funding Acquisition. 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