Nutcracker Esophagus: Investigation In A Female Patient With Dysphagia And Odinophagy

Introduction: Odinophagia and dysphagia are important symptoms related to the upper gastrointestinal tract, specifically at the level of the oropharynx and esophagus. Objective: to investigate the possible cause of these symptoms through clinical history and complementary exams, thus outlining a more specific approach. Methodology: anamnesis was performed followed by neck ultrasound, fine needle aspiration (FNAP), videolaryngoscopy, computed tomography of the neck, ultrasound with thyroid dopller, esophagogastroduodenal seriography, esophageal manometry, hormone and thyroid antibodies dosage, and evaluation of thyroid antibodies. speech therapy. Results: neck ultrasound with topical thyroid gland, diffusible to swallow, diffusely heterogeneous, mixed nodule in upper / middle and anterior third of the left lobe measuring about 2.2cm x 1.6cm x 1.0 cm, in addition to sparse colloidal cysts by the glandular parenchyma, no larger than 0.6 cm, cervical lymph nodes increased in number and dimensions, some coalescent, the largest being located in the left submandibular region, measuring 1.8 cm in its longest axis. US-guided FNAB: Oncotic Cytology- Benign nodule (Category II of the Bethesda system) consistent with benign follicular nodule (Colloid goiter). Paraffin inclusion- Some follicular epithelial ceslls, in addition to leukocytes, amidst eosinophilic background (system I category) Bethesda). High digestive endoscopy without changes. Videolaryngoscopy without alterations. Computed tomography of the neck showing homogeneous prominent palatine tonsils. Heterogeneous thyroid lobes. Submandibular prominent lymph node on the right (IIA) measuring 1.1 cm. Ultrasonography with thyroid doppler confirms the p revious findings. Manometry showed hypertonia of the lower esophageal sphincter, compatible with nutcracker esophagus. Final Considerations: A patient admitted to investigate dysphagia with two months of evolution associated with odynophagia reaches a final diagnosis of nutcracker esophagus, in addition to a benign thyroid nodule. Thus, the investigation should be supplemented on an outpatient basis with high-resolution manometry. He is discharged with a medical prescription and guidance to start monitoring with a gastroenterologist.

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Intraorbital wooden foreign body detected by computed tomography and magnetic resonance imaging

The Neuroradiology Journal ◽

10.1177/1971400916678245 ◽

2016 ◽

Vol 30 (1) ◽

pp. 88-91 ◽

Cited By ~ 3

Author(s):

Alfredo Di Gaeta ◽

Francesco Giurazza ◽

Eugenio Capobianco ◽

Alvaro Diano ◽

Mario Muto

Keyword(s):

Computed Tomography ◽

Foreign Body ◽

Magnetic Resonance ◽

Delayed Diagnosis ◽

Clinical History ◽

Definitive Diagnosis ◽

Double Vision ◽

Resonance Imaging ◽

Wooden Foreign Body ◽

The Right

To identify and localize an intraorbital wooden foreign body is often a challenging radiological issue; delayed diagnosis can lead to serious adverse complications. Preliminary radiographic interpretations are often integrated with computed tomography and magnetic resonance, which play a crucial role in reaching the correct definitive diagnosis. We report on a 40 years old male complaining of pain in the right orbit referred to our hospital for evaluation of eyeball pain and double vision with an unclear clinical history. Computed tomography and magnetic resonance scans supposed the presence of an abscess caused by a foreign intraorbital body, confirmed by surgical findings.

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Assessment of cervical lymph node metastases using indirect computed tomography lymphography with iopamidol in a tongue VX2 carcinoma model

The Journal of Laryngology & Otology ◽

10.1017/s0022215111000958 ◽

2011 ◽

Vol 125 (8) ◽

pp. 820-828 ◽

Cited By ~ 4

Author(s):

Y Shu ◽

X Xu ◽

Z Wang ◽

W Dai ◽

Y Zhang ◽

...

Keyword(s):

Computed Tomography ◽

Lymph Node ◽

Lymph Nodes ◽

Lymph Node Metastases ◽

Cervical Lymph Node ◽

Cervical Lymph Nodes ◽

Cervical Lymph Node Metastases ◽

Computed Tomography Images ◽

Vx2 Carcinoma ◽

Node Metastases

AbstractObjective:To investigate the performance of indirect computed tomography lymphography with iopamidol for detecting cervical lymph node metastases in a tongue VX2 carcinoma model.Materials and methods:A metastatic cervical lymph node model was created by implanting VX2 carcinoma suspension into the tongue submucosa of 21 rabbits. Computed tomography images were obtained 1, 3, 5, 10, 15 and 20 minutes after iopamidol injection, on days 11, 14, 21 (six rabbits each) and 28 (three rabbits) after carcinoma transplantation. Computed tomography lymphography was performed, and lymph node filling defects and enhancement characteristics evaluated.Results:Indirect computed tomography lymphography revealed bilateral enhancement of cervical lymph nodes in all animals, except for one animal imaged on day 28. There was significantly slower evacuation of contrast in metastatic than non-metastatic nodes. A total of 41 enhanced lymph nodes displayed an oval or round shape, or local filling defects. One lymph node with an oval shape was metastatic (one of 11, 9.1 per cent), while 21 nodes with filling defects were metastatic (21/30, 70 per cent). The sensitivity, specificity, accuracy, and positive and negative predictive values when using a filling defect diameter of 1.5 mm as a diagnostic criterion were 86.4, 78.9, 82.9, 82.6 and 83.3 per cent, respectively.Conclusion:When using indirect computed tomography lymphography to detect metastatic lymph nodes, filling defects and slow evacuation of contrast agent are important diagnostic features.

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Drug and alcohol in pregnancy and stuttering - a speech-language pathology case report

Revista CEFAC ◽

10.1590/1982-021620171957417 ◽

2017 ◽

Vol 19 (5) ◽

pp. 726-732

Author(s):

Mahyara Francini Jacob ◽

Camilla Guarnieri ◽

Isabela Alves de Quadros ◽

Simone Aparecida Lopes-Herrera

Keyword(s):

Drug Use ◽

Speech Therapy ◽

Child Language ◽

Clinical History ◽

Language Fluency ◽

Post Intervention ◽

Narrative Skills ◽

Assessment Tests ◽

Language Disabilities ◽

Development Of Language

ABSTRACT Drug use during pregnancy is a well-known risk factor for the manifestation of speech-language disabilities. However, the necessity of studies directed towards drug use and its influence on interventional speech process in cases of alterations of child language and fluency is observed. In this study, clinical history data are presented as well as pre and post-assessment tests (Speech and Language) and the description of an interventional process of a six-year child. The main communication complaint about the child was stuttering. In addition to the child’s clinical history, there was also knowledge of alcohol and legal and illegal drug use by the mother from before the moment of conception until this intervention process was reported. The protocols Stuttering Severity Instrument (SSI), Child Language Test (ABFW): phonology, vocabulary, and fluency tests, along with the Checklist of Verbal Communication Skills were applied. Based on these assessments, the child was diagnosed with mild to moderate stuttering, phonological simplifications, vocabulary inferior to that expected for his age, difficulty maintaining communicative turns, simplified narrative skills, alterations in psycholinguistic processes, and complaints from the school about his learning. The child underwent speech therapy in the areas of fluency and Child Language (phonological approach), showing evolution in the post-intervention assessment. Thus, in the present case, it became clear that the concomitant use of alcohol with exposure to cigarettes and marijuana may trigger changes in the acquisition and development of language, fluency and, consequently, learning.

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Computed tomography appearance of marked keratinization of metastatic cervical lymph nodes

Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology ◽

10.1016/s1079-2104(97)90351-6 ◽

1997 ◽

Vol 84 (3) ◽

pp. 321-326 ◽

Cited By ~ 1

Author(s):

Eiji Nakayama ◽

Eiichiro Ariji ◽

Masanori Shinohara ◽

Kazunori Yoshiura ◽

Kunihiro Miwa ◽

...

Keyword(s):

Computed Tomography ◽

Lymph Nodes ◽

Cervical Lymph Nodes ◽

Tomography Appearance

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Managing Incidentalomas Safely: Do Computed Tomography Requisitions Tell Us What We Need to Know?

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2016.11.004 ◽

2017 ◽

Vol 68 (4) ◽

pp. 387-391

Author(s):

Matthew Walker ◽

Joy Borgaonkar ◽

Daria Manos

Keyword(s):

Computed Tomography ◽

Incidental Findings ◽

Tertiary Care ◽

Clinical History ◽

Patient Questionnaire ◽

Prior History ◽

Care Hospital ◽

History Of ◽

Patient’S History ◽

History Of Cancer

Purpose Technological advancements and the ever-increasing use of computed tomography (CT) have greatly increased the detection of incidental findings, including tiny pulmonary nodules. The management of many “incidentalomas” is significantly influenced by a patient's history of cancer. The study aim is to determine if CT requisitions include prior history of malignancy. Methods Requisitions for chest CTs performed at our adult tertiary care hospital during April 2012 were compared to a cancer history questionnaire, administered to patients at the time of CT scan. Patients were excluded from the study if the patient questionnaire was incomplete or if the purpose of the CT was for cancer staging or cancer follow-up. Results A total of 569 CTs of the chest were performed. Of the 327 patients that met inclusion criteria, 79 reported a history of cancer. After excluding patients for whom a history of malignancy could not be confirmed through a chart review and excluding nonmelanoma skin cancer, dysplasia, and in situ neoplasm, 68 patients were identified as having a history of malignancy. We found 44% (95% confidence interval [0.32-0.57]) of the chest CT requisitions for these 68 patients did not include the patient's history of cancer. Of the malignancies that were identified by patient questionnaire but omitted from the clinical history provided on the requisitions, 47% were malignancies that commonly metastasize to the lung. Conclusions A significant number of requisitions failed to disclose a history of cancer. Without knowledge of prior malignancy, radiologists cannot comply with current guidelines regarding the reporting and management of incidental findings.

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Preoperative evaluation of cervical lymph nodes for metastasis in patients with oral squamous cell carcinoma: A comparative study of efficacy of palpation, ultrasonography and computed tomography

National Journal of Maxillofacial Surgery ◽

10.4103/0975-5950.199350 ◽

2017 ◽

Vol 0 (0) ◽

pp. 0

Author(s):

Niranjan Mishra ◽

KrushnaChandra Rath ◽

UpendraNath Upadhyay ◽

Subhrajit Raut ◽

ShadabAli Baig ◽

...

Keyword(s):

Computed Tomography ◽

Squamous Cell Carcinoma ◽

Oral Squamous Cell Carcinoma ◽

Comparative Study ◽

Lymph Nodes ◽

Cell Carcinoma ◽

Squamous Cell ◽

Preoperative Evaluation ◽

Cervical Lymph Nodes

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Malignant Transformation of an Enchondroma of the Hand: A Case Report

Revista Iberoamericana de Cirugía de la Mano ◽

10.1055/s-0039-1698814 ◽

2019 ◽

Vol 48 (02) ◽

pp. 128-132

Author(s):

María Jesús Rivera Vegas

Keyword(s):

Computed Tomography ◽

Malignant Transformation ◽

Clinical History ◽

Middle Phalanx ◽

Medical Visit ◽

Left Hand ◽

Fourth Finger ◽

Computed Tomography Scans ◽

Transformation Potential ◽

Sarcomatous Degeneration

AbstractWe present the case of the transformation of an enchondroma in the middle phalanx of the fourth finger of the left hand into a chondrosarcoma. The patient presented a lesion with clinical history, examination, and radiology findings consistent with an enchondroma, which was conservatively treated. Two years later, the patient came for a medical visit with a clinical and radiological variation of the lesion. Computed tomography scans and biopsy revealed a lesion with sarcomatous degeneration which was confirmed after the controlled amputation of the fourth finger. The malignant transformation potential of an enchondroma must be considered.

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