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Assembly

Difficulty Swallowing

Authors
Sushilkumar Satish Gupta1* M.D., Nikhil Cordeiro2 M.B.B.S. Jessell Posada3 MS, CCC-SLP, Stephan Kamholz4 M.D.
1 Fellow, Department of Pulmonary and Critical Care Medicine, Maimonides Medical Center, Brooklyn, NY, USA.
2 Resident, Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY, USA.
3 Speech – language pathologist, Maimonides Medical Center, Brooklyn, NY, USA.
4 Chairman, Department of Medicine, Maimonides Medical Center, Brooklyn, NY, USA.


Case

A 67-year-old man presents with productive cough, shortness of breath and dysphagia of one-week duration. He has a history of laryngeal cancer treated with radiation and chemotherapy, and has residual left laryngeal nerve paralysis, as well as lung cancer which was treated by left upper lobectomy. He complains of regurgitation of solids and liquids through his mouth and nose when swallowing. A modified barium swallow study is performed and the findings are shown in Figure 1 and Video 1.

Figure 1: Anterior-Posterior view of modified barium swallow study
Figure 1: Anterior-Posterior view of modified barium swallow study
Video 1: Passage of contrast during modified barium swallow study
Video 1: Passage of contrast during modified barium swallow study

Question

What best describes the images you see in Figure 1 and Video 1?

A. Schatzki’s ring
B. Diffuse esophageal spasm
C. Aspiration
D. Zenker’s diverticulum
E. Esophageal achalasia

Answer