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Notes:
Volume 8 Journal of Gastrointestinal & Digestive System
ISSN: 2161-069X
Page 32
JOINT EVENT
Pediatric Gastro 2018
Digestive Diseases 2018
October 22-23, 2018
October 22-23, 2018 Berlin, Germany
3rd International Conference on
Digestive and Metabolic Diseases
Pediatric Gastroenterology Hepatology & Nutrition
13th International Conference on
&
A curious case of dysphagia
Puneet Pal Singh and Bhavna Gilani
Basildon and Thurrock University Hospitals - NHS Foundation Trust, UK
Asixty three year old gentleman with a history of bipolar disorder was admitted with 2 day history of pyrexia, non productive
cough and collapse. On further questioning, patient complained of a 10 months progressive history of dysphagia. Clinical
examination was notable for vesicular breathing and left basal crepitations. Neurological examination was unremarkable with
no demonstrable fatiguability. ECG revealed normal sinus rhythm. Laboratory studies showed raised inflammatory markers
and chest film revealed left basal consolidation in keeping with a community acquired pneumonia. A course of co-amoxiclav
and clarithromycin were prescribed but due to persistent pyrexia gentamicin cover was added. Patchy consolidation was noted
on CT chest, abdomen and pelvis. Whilst being treated for pneumonia, the patient developed worsening dysphagia to both
solids and liquids. Patient denied odynophagia or vomiting; was seen by the speech and language therapist who deemed him
to have unsafe swallowing and consequently was NG (Nasogastric) fed and treated for aspiration pneumonia with teicoplanin,
metronidazole and temocillin with resolution after 12 days of treatment. Inpatient OGD (oesophago gastroduodenoscopy),
MRI head studies, flexible nasoendoscopy and EMG (electromyography) studies were unremarkable. Videofluoroscopy study
demonstrated anterior disc osteophyte bar at the level of C3/C4 causing extrinsic compression of the pharynx. Pharyngeal
aspiration was also noted. Subsequent CT examination revealed significant anterior undulating ossification in relation to
multiple cervical vertebral bodies with extrinsic compression of oesophagus from these ossific foci in keeping with a diagnosis
of diffuse idiopathic skeletal hyperosteosis by exclusion. Patient was referred for neurological intervention. C3-C5 anterior
osteophyte removal was performed with resolution of dysphagia.
Biography
Dr. Puneet Pal Singh graduated from Charles University in Prague as a Medical Doctor. Previously completed B.S.c in Biochemistry and M.S.c in Molecular
Medicine from Imperial College of Science and Technology in London. Later on he completed his core medical training at Lister Hospital in Stevenage, UK.
Presently he has been working at Basildon Hospital as a Registrar in Renal Medicine.
Puneet Pal Singh et al., J Gastrointest Dig Syst 2018, Volume 8
DOI: 10.4172/2161-069X-C7-083