Dysphagia DDx
Overview
Differential diagnosis of dysphagia – difficulty swallowing.
Causes
Mechanical obstruction
- Intrinsic (within oesophagus)
— Reflux oesophagitis with stricture formation
— Carcinoma of oesophagus or gastric cardia
— Pharyngeal or oesophageal web
— Pharyngeal pouch
— Schatzki (lower oesophageal) ring
— Foreign body - Extrinsic (outside oesophagus)
— Goitre with retrosternal extension
— Mediastinal tumours, bronchial carcinoma, vascular compression (rare)
Neuromuscular motility disorders (hints from the history: solids and liquids equally difficult, symptoms intermittent)
- Achalasia
- Diffuse oesophageal spasm
- Scleroderma
Pharyngeal dysphagia (hints: aspiration, fluid regurgitation into the nose)
- Cricopharyngeal dysfunction – Zenker diverticulum
Neurological diseases
- bulbar or pseudobulbar palsy
- myasthenia gravis
- polymyositis
- myotonic dystrophy
Psychiatric
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Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.
His one great achievement is being the father of three amazing children.
On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.
| INTENSIVE | RAGE | Resuscitology | SMACC