Dysphagia....

RE: Dysphagia....

Stephanie Wellings — Thu, 18 May 2017 16:37:55 GMT

Thymoma could explain the mediastinal mass and cause myaesthenia explaining the megaoesophagus/weakness? There is a (slightly depressing) case study here - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1716736/

RE: Dysphagia....

Martin Atkinson — Thu, 18 May 2017 16:35:58 GMT

Oesophagus grossly dilated and filled with air, right ventricular hypertrophy. Myasthenia Gravis/dysautonomia with coincidental cardiac disease?

RE: Dysphagia....

Gillian Mostyn — Thu, 18 May 2017 15:37:45 GMT

Thank-you - you've both said what I thought - mediastinal widening, loss of cranial border of heart and lots of air in oesophagus.

Incidentally, I struggled to pass the ET tube - managed to get it just past thoracic inlet but no further, which I've never seen before. It wasn't excessively large so..??? odd

RE: Dysphagia....

Robin Grimmer — Thu, 18 May 2017 15:16:51 GMT

The oesophagus looks abnormal/dilated. Also, there is some air bronchograms present - could be eg poss aspiration pneumonia, but may just be because expiratory view.Any regurgitation? I would GA scope, get some inflated views +- contrast in the oesophagus.

RE: Dysphagia....

Linda Filshie — Thu, 18 May 2017 15:16:28 GMT

Caudal oesophagus appears dilated, on dv the mediastinum looks enlarged/widened and on both lats it's difficult to make out the cranial border of the heart - not sure if this is opacity in the lung fields or just fat triceps area overlying the area. Difficulty with hard food could well be due to dental disease, but acquired megaoesophagus and cardiac disease still on the list.

Interested to see what others think. Disclaimer: looking at these on my phone!

RE: Dysphagia....

Gillian Mostyn — Thu, 18 May 2017 14:19:41 GMT

Sorry - quality not great as photo of a film. The top radiograph left lateral, second is right lateral - obviously there are a couple of artifacts (drip line hiding under the dog!!)