Open AccessA rare cause of dysphagia and gastroparesis
Author(s) -
K. P. Basavaraju,
Dina Mansour,
Stuart J. Barnes,
M. Whitehead,
Stuart Bruce
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.07.2008.0358
Subject(s) - medicine , dysphagia , lethargy , vomiting , heartburn , gastroparesis , weight loss , aspiration pneumonia , odynophagia , anorexia , physical examination , gastroenterology , surgery , stomach , pneumonia , gastric emptying , reflux , disease , obesity
An 82-year-old woman was admitted with severe vomiting and progressive dysphagia mainly to solids. She gave a 3-month history of increasing heartburn, vomiting, tiredness, lethargy, anorexia and 13 kg weight loss. Her past medical history was unremarkable and she was a non-smoker. Physical examination revealed evidence of significant weight loss and dehydration only. Gastroscopy revealed mild oesophagitis, tongues of Barrett oesophagus and mild antral gastritis. CT scan of the thorax and abdomen was normal. Unfortunately her condition deteriorated rapidly and she died from aspiration pneumonia. Postmortem examination revealed thickening of the muscular wall of lower oesophagus and pylorus, but without any malignancy. The histological assessment of the oesophageal as well as gastric biopsies confirmed the diagnosis of gastrointestinal amyloidosis accounting for her symptoms of dysphagia and vomiting respectively.