Images in Gas oen e ology and Hepa ology
GE Po J Gas oen e ol 2022;29:215–216
Spinal Os eophy osis: An Uncommon
Cause o Dysphagia
And eia De Ma os
a, b C is iane Macedo
a Pa ícia A onso Mendes
a, b
a In e nal Medicine, Coimb a Hospi al and Uni e si y Cen e , Coimb a, Po ugal; b Clinical Medicine, Facul y o
Medicine, Uni e si y o Coimb a, Coimb a, Po ugal
Recei ed: No embe 19, 2020
Accep ed: Janua y 23, 2021
Published online: Ma ch 29, 2021
And eia De Ma os
In e nal Medicine
Coimb a Hospi al and Uni e si y Cen e
PT–3200–408 Coimb a (Po ugal)
a.ma ga ida_ma os @ ho mail.com
© 2021 Sociedade Po uguesa de Gas en e ologia.
Published by S. Ka ge AG, Basel
ka ge @ka ge .com
www.ka ge .com/pjg
DOI: 10.1159/000514780
Keywo ds
Spinal os eophy osis · O opha yngeal dysphagia
Os eo i ose Ce ical: Uma Causa Incomum de
Dis agia
Pala as Cha e
Os eo i ose ce ical · Dis agia o o a íngea
A Caucasian 60-yea -old man, wi h a ca ee in house-
building, p esen ed wi h mild, ch onic and p og essi e
dysphagia, mani es ed by di icul y in swallowing solid
ood o he las 6 mon hs. He had no ce ical pain, weigh
loss, dysphonia, espi a o y complain s, p e ious su gical
in e en ion, adio he apy, majo auma, myogenic o
me abolic known causes o his symp om. The pa ien
had a no mal ce ical and ches physical examina ion and
neu ologic exam. A ba ium swallow es was i s ly pe -
o med, e ealing a pos e io esophagus inden a ion due
o an os eophy e o ma ion, which in e e ed wi h con-
as p og ession. This exam also uled ou dys unc ion in
mo ili y o a Zenke ’s di e iculum. Consequen ly, o be -
e cha ac e ize he os eoa icula disease, he pa ien was
submi ed o a compu ed omog aphy (CT) and ce ical
magne ic esonance imaging (MRI) which e ealed de-
gene a i e changes such as: an e io and la e al p o u-
sion o e eb al discus, os eophy es om C3 o C5, un-
ca h osis, and pos e io C3 o C6 in e apophysa y hy-
pe ophic a h osis, wi hou ligamen calci ica ion o
ce ical webs (Fig.1a–c). Finally, uppe diges i e endos-
copy uled ou in insic abno mali ies, and ce ical ul a-
sound was also no mal.
Ce ical os eophy es occu in 20–30% o he gene al
popula ion [1] and a e mos ly associa ed wi h di use id-
iopa hic skele al hype os osis and ankylosing spondyli is
[2]. Mos os eophy es o he an e io ma gin o he ce i-
cal spine a e asymp oma ic. Ne e heless, ce ical os eo-
phy es we e he cause o dysphagia in 11.7% o a s udied
popula ion, wi h a mean age o 79 ± 8 yea s [3, 4], disclos-
ing a possible unde ecognized e iology. In his ma e ,
acco ding o Lee e al. [5], pa ien s wi h his condi ion
we e usually men (81%), wi h a mean age o 68 yea s and
he C3 o C6 le el mos commonly in ol ed, ypically
p esen ing wi h a long his o y o dysphagia. O he symp-
oms include ood impac ion, dysphonia and espi a o y
obs uc ion [2, 3]. The diagnos ic imaging app oach in-
cludes a la e al X- ay, ba ium swallow, and ce ical CT o
MRI. Su gical app oach may be a de ini e solu ion, bu
die es ic ions may cause sa is ac o y imp o emen [1–
3, 5]. Ou pa ien was paucisymp oma ic and emains
only wi h adap ed die . The au ho s highligh an e io
ce ical os eophy osis as a di e en ial diagnosis o o o-
pha yngeal dysphagia.
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DeMa os/Macedo/A onsoMendes
GE Po J Gas oen e ol 2022;29:215–216
216
DOI: 10.1159/000514780
S a emen o E hics
The au ho s s a ed ha he subjec ga e in o med consen o
publish his case.
Con lic o In e es S a emen
The au ho s ha e no con lic s o in e es o decla e.
Funding Sou ces
No unding was ecei ed.
Au ho Con ibu ions
All au ho s con ibu ed equally o da a acquisi ion, w i ing and
app o al o he inal e sion o he pape and ag eed o all aspec s
o he wo k in ensu ing ha ques ions ela ed o he accu acy o
in eg i y o any pa o he wo k we e app op ia ely in es iga ed
and esol ed.
a
b
c
Fig. 1. a C3 soma ic ma ginal os eophy e (whi e ci cle) on CT. b Ce ical MRI wi h an e io and la e al p o u-
sion o he e eb al discus and os eophy es in C3 o C5. c Ba ium swallows wi h pos e io esophagus inden a ion
a he le el o he os eophy e o ma ion.
Re e ences
1 Akbal A, Ku a an A, Selcuk B, Gu can A, E -
soz M, Akyuz M. The de elopmen o dyspha-
gia and dysphonia due o an e io ce ical os-
eophy es. Rheuma ol In . 2009 Jan; 29(3):
331–4.
2 Maka am N, Gohil R, Majumda S. Dyspha-
gia due o oesophageal obs uc ion: A case e-
po o unusual occupa ional ae iology. Ann
Med Su g (Lond). 2015 No ; 4(4): 438–43.
3 Gige R, Dulgue o P, Paye M. An e io ce -
ical os eophy es causing dysphagia and dys-
pnea: an uncommon en i y e isi ed. Dyspha-
gia. 2006 Oc ; 21(4): 259–63.
4 Hee Eun Choi, e al. Cha ac e is ics and Clin-
ical Cou se o Dysphagia Caused by An e io
Ce ical Os eophy e. Ann Rehabil Med. 2019
Feb; 43(1): 27–37. h ps://doi.o g/10.5535/
a m.2019.43.1.27.
5 Lee, Seung Ah, MD; Kim, Kyung Eun, MD;
Paik, Nam-Jong, MD, PhD Dysphagia caused
by mul ile el ce ical os eophy es. Am J Phys
Med Rehabil. 2008 Jul; 87(7): 607. h ps://doi.
o g/10.1097/PHM.0b013e31817c496b.