Diffuse esophageal spasm differential diagnosis: Difference between revisions
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|Reflux esophagitis | |Reflux esophagitis | ||
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* Dysphagia (from peptic stricture) | * [[Dysphagia]] (from peptic stricture) | ||
* Heartburn | * [[Heartburn]] | ||
* Hoarseness | * [[Hoarseness]] | ||
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* Poor clearance | * Poor clearance | ||
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|Esophageal carcinoma | |Esophageal carcinoma | ||
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* Dysphagia (initially for solids, liquids develops with advanced disease.) | * [[Dysphagia]] (initially for solids, liquids develops with advanced disease.) | ||
* Weight loss | * [[Weight loss]] | ||
* Lymphadenopathy | * [[Lymphadenopathy]] | ||
* Cachexia | * [[Cachexia]] | ||
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* Irregular stricture | * Irregular stricture | ||
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|Systemic sclerosis | |Systemic sclerosis | ||
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* Dysphagia | * [[Dysphagia]] | ||
* Muscle and joint pain | * Muscle and joint pain | ||
* Raynaud's phenomenon | * [[Raynaud's phenomenon]] | ||
* Skin changes (rash, skin thickening) | * Skin changes (rash, skin thickening) | ||
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|Pseudoachalasia | |Pseudoachalasia | ||
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* Dysphagia | * [[Dysphagia]] | ||
* Weight loss | * [[Weight loss]] | ||
* Lymphadenopathy | * [[Lymphadenopathy]] | ||
* Appetite changes | * Appetite changes | ||
* Cachexia | * [[Cachexia]] | ||
* Older patients | * Older patients | ||
* Underlying malignancy that mimics idiopathic achalasia. | * Underlying malignancy that mimics idiopathic [[achalasia]]. | ||
* Patients tend to be older, duration of symptoms shorter, and weight loss greater and more rapid. | * Patients tend to be older, duration of symptoms shorter, and weight loss greater and more rapid. | ||
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|Chagas disease | |Chagas disease | ||
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* Dysphagia | * [[Dysphagia]] | ||
* Toxic megacolon | * [[Toxic megacolon]] | ||
* Myocarditis | * [[Myocarditis]] | ||
* Blepharitis | * [[Blepharitis]] | ||
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* Esophageal dilatation | * Esophageal dilatation | ||
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|Pharyngitis | |Pharyngitis | ||
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* Dysphagia | * [[Dysphagia]] | ||
* Fever | * [[Fever]] | ||
* Throat pain | * Throat pain | ||
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|Esophageal candidiasis | |Esophageal candidiasis | ||
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* Dysphagia | * [[Dysphagia]] | ||
* Immunocompromised | * [[Immunocompromised host|Immunocompromised]] | ||
* History of corticosteroid | * History of [[corticosteroid]] | ||
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* Shaggy" appearance (plaques) | * Shaggy" appearance (plaques) | ||
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|Stroke | |Stroke | ||
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* Progressive dysphagia | * Progressive [[dysphagia]] | ||
* Dysarthria | * [[Dysarthria]] | ||
* Limb weakness | * Limb weakness | ||
* Fatigue | * [[Fatigue]] | ||
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* Pooling of contrast in the pharynx | * Pooling of contrast in the pharynx | ||
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* Dyspnea<ref>{{cite book | last = Ferri | first = Fred | title = Ferri's clinical advisor 2015 : 5 books in 1 | publisher = Elsevier/Mosby | location = Philadelphia, PA | year = 2015 | isbn = 978-0323083751 }}</ref> | * [[Dyspnea]]<ref>{{cite book | last = Ferri | first = Fred | title = Ferri's clinical advisor 2015 : 5 books in 1 | publisher = Elsevier/Mosby | location = Philadelphia, PA | year = 2015 | isbn = 978-0323083751 }}</ref> | ||
*[[Dysphagia]] for solids and liquids is the most common feature, being seen in 91 % and 85% of patients respectively<ref name="pmid23871090">{{cite journal| author=Boeckxstaens GE, Zaninotto G, Richter JE| title=Achalasia. | journal=Lancet | year= 2013 | volume= | issue= | pages= | pmid=23871090 | doi=10.1016/S0140-6736(13)60651-0 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23871090 }}</ref> | *[[Dysphagia]] for solids and liquids is the most common feature, being seen in 91 % and 85% of patients respectively<ref name="pmid23871090">{{cite journal| author=Boeckxstaens GE, Zaninotto G, Richter JE| title=Achalasia. | journal=Lancet | year= 2013 | volume= | issue= | pages= | pmid=23871090 | doi=10.1016/S0140-6736(13)60651-0 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23871090 }}</ref> | ||
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*Patient may present with the symptoms of the underlying GERD. | *Patient may present with the symptoms of the underlying [[Gastroesophageal reflux disease|GERD]]. | ||
*Dysphagia and odynophagia.<ref name="pmid17227515">{{cite journal |vauthors=Ruigómez A, García Rodríguez LA, Wallander MA, Johansson S, Eklund S |title=Esophageal stricture: incidence, treatment patterns, and recurrence rate |journal=Am. J. Gastroenterol. |volume=101 |issue=12 |pages=2685–92 |year=2006 |pmid=17227515 |doi=10.1111/j.1572-0241.2006.00828.x |url=}}</ref> | *[[Dysphagia]] and [[odynophagia]].<ref name="pmid17227515">{{cite journal |vauthors=Ruigómez A, García Rodríguez LA, Wallander MA, Johansson S, Eklund S |title=Esophageal stricture: incidence, treatment patterns, and recurrence rate |journal=Am. J. Gastroenterol. |volume=101 |issue=12 |pages=2685–92 |year=2006 |pmid=17227515 |doi=10.1111/j.1572-0241.2006.00828.x |url=}}</ref> | ||
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Revision as of 16:58, 14 November 2017
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Diffuse esophageal spasm Microchapters |
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Differentiating Diffuse esophageal spasm from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Diffuse esophageal spasm differential diagnosis On the Web |
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American Roentgen Ray Society Images of Diffuse esophageal spasm differential diagnosis |
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Risk calculators and risk factors for Diffuse esophageal spasm differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Madhu Sigdel M.B.B.S.[2]
Overview
Diffuse esophageal spasm must be differentiated from other diseases that cause dysphagia, chest pain and weight loss such as angina, reflux esophagitis, esophageal carcinoma, systemic sclerosis, nutcracker esophagus, hypertensive LES, esophageal web/stricture, pseudoachalasia, stroke, esophageal candidiasis and Chagas disease etc.
Differential Diagnosis
Diffuse esophageal spasm must be differentiated from other diseases that cause dysphagia, chest pain and weight loss such as angina, reflux esophagitis, esophageal carcinoma, systemic sclerosis, nutcracker esophagus, hypertensive LES, esophageal web/stricture, pseudoachalasia, stroke, esophageal candidiasis and Chagas disease etc.[1][2][3][4][5][6][7][8][9][10][11]
| Disease | Signs & Symptoms | Findings on barium esophagogram | Findings on endoscopy | Other findings |
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| Reflux esophagitis |
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| Angina | Chest pain related to exertion
Dysphagia |
Normal | Normal | ST segment elevation on ECG |
| Esophageal carcinoma |
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| Systemic sclerosis |
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Positive serology for
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| Pseudoachalasia |
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| Chagas disease |
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| Pharyngitis |
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| Esophageal candidiasis |
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| Stroke |
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| Manifestations | Diagnostic tools | ||||
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| Achalasia |
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| GERD |
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| Esophageal carcinoma |
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| Esophageal stricture |
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| Plummer-Vinson syndrome | Common symptoms of Plummer-Vinson syndrome include:[9][10][11]
Less common symptoms
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Lab tests are consistent with the diagnosis of iron deficiency anemia.
Findings on an x-ray (barium esophagogram) suggestive of esophageal web/strictures associated with Plummer-Vinson syndrome appear as either:
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References
- ↑ Ferri, Fred (2015). Ferri's clinical advisor 2015 : 5 books in 1. Philadelphia, PA: Elsevier/Mosby. ISBN 978-0323083751.
- ↑ 2.0 2.1 2.2 2.3 Boeckxstaens GE, Zaninotto G, Richter JE (2013). "Achalasia". Lancet. doi:10.1016/S0140-6736(13)60651-0. PMID 23871090.
- ↑ 3.0 3.1 Badillo R, Francis D (2014). "Diagnosis and treatment of gastroesophageal reflux disease". World J Gastrointest Pharmacol Ther. 5 (3): 105–12. doi:10.4292/wjgpt.v5.i3.105. PMC 4133436. PMID 25133039.
- ↑ 4.0 4.1 4.2 Napier KJ, Scheerer M, Misra S (2014). "Esophageal cancer: A Review of epidemiology, pathogenesis, staging workup and treatment modalities". World J Gastrointest Oncol. 6 (5): 112–20. doi:10.4251/wjgo.v6.i5.112. PMC 4021327. PMID 24834141.
- ↑ Matsuura H (2017). "Diffuse Esophageal Spasm: Corkscrew Esophagus". Am. J. Med. doi:10.1016/j.amjmed.2017.08.041. PMID 28943381.
- ↑ Lassen JF, Jensen TM (1992). "[Corkscrew esophagus]". Ugeskr. Laeg. (in Danish). 154 (5): 277–80. PMID 1736462.
- ↑ 7.0 7.1 Ruigómez A, García Rodríguez LA, Wallander MA, Johansson S, Eklund S (2006). "Esophageal stricture: incidence, treatment patterns, and recurrence rate". Am. J. Gastroenterol. 101 (12): 2685–92. doi:10.1111/j.1572-0241.2006.00828.x. PMID 17227515.
- ↑ 8.0 8.1 Shami VM (2014). "Endoscopic management of esophageal strictures". Gastroenterol Hepatol (N Y). 10 (6): 389–91. PMC 4080876. PMID 25013392.
- ↑ 9.0 9.1 López Rodríguez MJ, Robledo Andrés P, Amarilla Jiménez A, Roncero Maíllo M, López Lafuente A, Arroyo Carrera I (2002). "Sideropenic dysphagia in an adolescent". J. Pediatr. Gastroenterol. Nutr. 34 (1): 87–90. PMID 11753173.
- ↑ 10.0 10.1 Chisholm M (1974). "The association between webs, iron and post-cricoid carcinoma". Postgrad Med J. 50 (582): 215–9. PMC 2495558. PMID 4449772.
- ↑ 11.0 11.1 Larsson LG, Sandström A, Westling P (1975). "Relationship of Plummer-Vinson disease to cancer of the upper alimentary tract in Sweden". Cancer Res. 35 (11 Pt. 2): 3308–16. PMID 1192404.
- ↑ Ferri, Fred (2015). Ferri's clinical advisor 2015 : 5 books in 1. Philadelphia, PA: Elsevier/Mosby. ISBN 978-0323083751.