{"id":215,"date":"2018-03-12T10:18:42","date_gmt":"2018-03-12T10:18:42","guid":{"rendered":"https:\/\/blogs.bmj.com\/fg\/?p=215"},"modified":"2018-09-10T11:36:46","modified_gmt":"2018-09-10T11:36:46","slug":"an-unusual-case-of-dysphagia","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/fg\/2018\/03\/12\/an-unusual-case-of-dysphagia\/","title":{"rendered":"An unusual case of dysphagia?"},"content":{"rendered":"<p>A 16 year-old girl was referred to our paediatric department due to intermittent dysphagia during six months. Occasionally, she needed to induce vomit to dispose of stuck food. She reported no odynophagia, no gastroesophageal reflux symptoms, no abdominal or retrosternal pain, and no changes to defecation patterns. The patient was otherwise healthy and average weight with no weight loss. She had no previous medical record, except acne vulgaris, treated with tetracycline 250 mg daily for three years. She lived with her parents and attended high school, and no psychosocial difficulties were reported.<br \/>\nThe patient had an unremarkable physical examination and was mentally age-appropriate. Blood tests revealed iron deficiency anaemia: haemoglobin 9.3 g\/dL (reference range: 11.3-15.8 g\/dL), ferritin 3 ng\/mL (5-92 ng\/mL) and mean cell volume 73 fL (82-98 fL). Leucocytes, thrombocytes, folic acid, cobalamin, sodium, potassium, ionic calcium, magnesium, creatinine, albumin, transglutaminase, gliadin peptide-antibodies and c-reactive protein were all within reference ranges. Rapid streptococcal test was negative and an allergy screening was performed with no findings. Eventually, an oesophagogastroduodenoscopy was performed, which revealed a mid-oesophageal, non-passable stenosis with several ulcerations and acute inflammation (Figure 1).<\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/fg\/files\/2018\/03\/Slide5.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-217\" src=\"https:\/\/blogs.bmj.com\/fg\/files\/2018\/03\/Slide5-300x169.png\" alt=\"\" width=\"300\" height=\"169\" srcset=\"https:\/\/blogs.bmj.com\/fg\/files\/2018\/03\/Slide5-300x169.png 300w, https:\/\/blogs.bmj.com\/fg\/files\/2018\/03\/Slide5.png 720w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/fg\/files\/2018\/03\/Slide6.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-218\" src=\"https:\/\/blogs.bmj.com\/fg\/files\/2018\/03\/Slide6-300x169.png\" alt=\"\" width=\"300\" height=\"169\" srcset=\"https:\/\/blogs.bmj.com\/fg\/files\/2018\/03\/Slide6-300x169.png 300w, https:\/\/blogs.bmj.com\/fg\/files\/2018\/03\/Slide6.png 720w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><br \/>\nQuestion: What is the likely diagnosis and what is the treatment?<\/p>\n<p>&nbsp;<\/p>\n<div class=\"\">\n<div class=\"\">\n<div>\n<blockquote class=\"\">\n<div class=\"\">\n<div class=\"\"><b class=\"\">Martin Brummerstedt, M\u00e4rta Borghede, Wojciech Cebula<\/b><\/div>\n<\/div>\n<\/blockquote>\n<blockquote class=\"\">\n<div class=\"\">\n<div class=\"\">Department of Internal Medicine<br class=\"\" \/>Nykobing F. Sygehus<br class=\"\" \/>Fjordvej 15<\/div>\n<\/div>\n<\/blockquote>\n<blockquote class=\"\">\n<div class=\"\">\n<div class=\"\">4800 Nykobing Falster<br class=\"\" \/>Denmark<\/div>\n<\/div>\n<\/blockquote>\n<\/div>\n<\/div>\n<\/div>\n<p><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A 16 year-old girl was referred to our paediatric department due to intermittent dysphagia during six months. Occasionally, she needed to induce vomit to dispose of stuck food. She reported no odynophagia, no gastroesophageal reflux symptoms, no abdominal or retrosternal pain, and no changes to defecation patterns. The patient was otherwise healthy and average weight [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/fg\/2018\/03\/12\/an-unusual-case-of-dysphagia\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":308,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10257],"tags":[],"class_list":["post-215","post","type-post","status-publish","format-standard","hentry","category-fgcaseofthemonth"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>An unusual case of dysphagia? - Frontline Gastroenterology Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/fg\/2018\/03\/12\/an-unusual-case-of-dysphagia\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"An unusual case of dysphagia? - Frontline Gastroenterology Blog\" \/>\n<meta property=\"og:description\" content=\"A 16 year-old girl was referred to our paediatric department due to intermittent dysphagia during six months. Occasionally, she needed to induce vomit to dispose of stuck food. She reported no odynophagia, no gastroesophageal reflux symptoms, no abdominal or retrosternal pain, and no changes to defecation patterns. The patient was otherwise healthy and average weight [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/fg\/2018\/03\/12\/an-unusual-case-of-dysphagia\/\" \/>\n<meta property=\"og:site_name\" content=\"Frontline Gastroenterology Blog\" \/>\n<meta property=\"article:published_time\" content=\"2018-03-12T10:18:42+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2018-09-10T11:36:46+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.bmj.com\/fg\/files\/2018\/03\/Slide5-300x169.png\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/fg\\\/2018\\\/03\\\/12\\\/an-unusual-case-of-dysphagia\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/fg\\\/2018\\\/03\\\/12\\\/an-unusual-case-of-dysphagia\\\/\"},\"author\":{\"name\":\"\",\"@id\":\"\"},\"headline\":\"An unusual case of dysphagia?\",\"datePublished\":\"2018-03-12T10:18:42+00:00\",\"dateModified\":\"2018-09-10T11:36:46+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/fg\\\/2018\\\/03\\\/12\\\/an-unusual-case-of-dysphagia\\\/\"},\"wordCount\":215,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/fg\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/fg\\\/2018\\\/03\\\/12\\\/an-unusual-case-of-dysphagia\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/fg\\\/files\\\/2018\\\/03\\\/Slide5-300x169.png\",\"articleSection\":[\"#FGCaseofthemonth\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/fg\\\/2018\\\/03\\\/12\\\/an-unusual-case-of-dysphagia\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/fg\\\/2018\\\/03\\\/12\\\/an-unusual-case-of-dysphagia\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/fg\\\/2018\\\/03\\\/12\\\/an-unusual-case-of-dysphagia\\\/\",\"name\":\"An unusual case of dysphagia? 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