A 16-year-old Caucasian male with previously diagnosed eosinophilic esophagitis (EoE) 4 years before his initial visit to an allergist-immunologist, scheduled due to severe dysphagia and recurrent food impaction. He had been off EoE therapy for 1 year. After resuming inhaled fluticasone and a proton pump inhibitor (PPI), esophagogastroduodenoscopy (EGD) was immediately scheduled. The dates of the original EGD procedures with the histological summary and EoE therapy are reported in the Table 1. The fourth endoscopy revealed near normal histology, with rare candida staining (Table 1). He was continued on daily PPI and the fluticasone was discontinued. Three weeks of Fluconazole failed to resolve his dysphagia. A repeat barium swallow confirmed a pre-existing cricopharyngeal bar, and he was referred to an otolaryngology for further care. [Table: see text].
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http://dx.doi.org/10.1089/ped.2024.0019 | DOI Listing |
J Clin Gastroenterol
February 2025
Digestive Disease and Surgery Institute, Cleveland Clinic London, UK.
Peroral endoscopic myotomy (POEM) is a novel technique within the field of third space endoscopy. The overarching principal is creation of a mucosal incision, careful dissection of the submucosal space using an electrosurgical knife to reach the muscularis (ie, tunneling), performing a controlled myotomy, and finally, closure of the mucosal incision. POEM was first developed for the management of achalasia, and now a decade of evidence shows the procedure is safe, effective, and highly reproducible.
View Article and Find Full Text PDFPediatr Allergy Immunol Pulmonol
September 2024
University of Nebraska Medical Center and Children's Hospital and Medical Center Omaha, Omaha, Nebraska, USA.
A 16-year-old Caucasian male with previously diagnosed eosinophilic esophagitis (EoE) 4 years before his initial visit to an allergist-immunologist, scheduled due to severe dysphagia and recurrent food impaction. He had been off EoE therapy for 1 year. After resuming inhaled fluticasone and a proton pump inhibitor (PPI), esophagogastroduodenoscopy (EGD) was immediately scheduled.
View Article and Find Full Text PDFBest Pract Res Clin Gastroenterol
August 2024
Gastroenterology Department Hospital Universitario de Navarra, NavarraBiomed, UPNA, IdiSNA, Spain. Electronic address:
Cricopharyngeal achalasia (CPA), also known as cricopharyngeal bar, is a rare motor disorder affecting the upper oesophageal sphincter. This comprehensive literature review focuses on clinical aspects that can assist physicians in daily decision-making. The diagnosis of CPA is primarily based on symptoms of upper dysphagia and radiological identification of a posterior bar.
View Article and Find Full Text PDFHead Neck
January 2025
Department of Otolaryngology, Westmead Hospital, Westmead, New South Wales, Australia.
Background: The presence of a pseudodiverticulum of the anterior pharyngeal wall, or prominent "pharyngeal bar," is a well-known phenomenon that occurs following total laryngectomy, which can be visualized by nasolaryngoscopy or videofluoroscopy. Among the different techniques of pharyngeal reconstruction, there is higher incidence following primary vertical multilayered closure. It has been postulated to cause dysphagia and lack of dietary progression despite a paucity of data.
View Article and Find Full Text PDFAnn Gastroenterol
February 2024
Digestive Diseases and Surgery Institute, Cleveland Clinic London (Benjamin Norton, Apostolis Papaefthymiou, Andrea Telese, Charles Murray, Rehan Haidry).
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