AN UNUSUAL CAUSE OF DYSPHAGIA: A CASE REPORT | ||
| African Journal of Gastroenterology and Hepatology | ||
| Volume 8, Issue 1, 2025, Pages 159-164 PDF (452.96 K) | ||
| Document Type: Case Reports | ||
| DOI: 10.21608/ajgh.2025.391272.1083 | ||
| Authors | ||
| Aba Folson* 1; Francis Essilfie2; Dennis Brempong2; Ernest Sowada2 | ||
| 1Department of Medicine and Theraputics School of Medicine University of Health and Allied Sciences PMB 31, Ho, Volta Region | ||
| 2Ho Teaching Hospital PMB 31, Ho, Volta Region | ||
| Abstract | ||
| Aims: To report an unusual case of dysphagia in an elderly patient caused by an anterior cervical osteophyte, and to highlight the importance of including plain cervical radiography in the diagnostic work-up of dysphagia, particularly in low-resource settings where advanced imaging may not always be available. Patient and Methods: We reviewed the clinical presentation, investigations, management, and outcome of a 63-year-old male who presented with a two-year history of progressive dysphagia, hoarseness of voice, significant weight loss, and recent-onset jaundice. A detailed history, physical examination, laboratory investigations, imaging studies (including plain radiographs, ultrasound, and CT scans), and response to conservative management were documented. Results: Initial endoscopy and laryngoscopy were unremarkable. The patient’s condition worsened, progressing to dysphagia for liquids and saliva retention. Laboratory results revealed severe anemia and deranged liver function tests. Abdominal ultrasound suggested hepatomegaly. A lateral neck radiograph and CT scan showed a prominent anterior cervical osteophyte at the C5 vertebra, confirming the structural cause of dysphagia. He was managed conservatively with fluids, antibiotics for concurrent pneumonia, blood transfusion, and supportive care, leading to clinical improvement. His liver function tests improved after he discontinued the herbal medications. The patient was subsequently referred for neurosurgical evaluation for definitive management of the osteophyte. Conclusion: Cervical osteophytes, although common in older people, rarely present with dysphagia. This case emphasizes the need to consider cervical osteophyte as a differential diagnosis of dysphagia in elderly patients. Plain cervical radiographs should be incorporated early in the diagnostic algorithm in resource-limited settings to facilitate timely detection and appropriate management. | ||
| Keywords | ||
| Dysphagia; cervical osteophyte; progressive dysphagia; laryngeal examination; structural obstruction; endoscopy; degenerative spine disease; C5 vertebra; anterior cervical spine | ||
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