Severe Esophageal Dysphagia, Weight Loss, and Atrial Fibrillation: A Devastating Outcome

Question: A 63-year-old man with a history of ischemic heart disease and atrial fibrillation presented with new-onset esophageal dysphagia to solids. One week prior he underwent coronary artery bypass surgery and left atrial radiofrequency ablation (RFA) for atrial fibrillation. He was first evaluated by a gastroenterologist from an outside facility. Barium swallow showed smooth tapering elongated stenosis of the mid esophagus with proximal esophageal dilatation (Figure A). He underwent an esophagogastroduodenoscopy (EGD) and was treated for presumed severe Candida esophagitis, even though esophageal brushings and histopathologic assessment were not diagnostic.

Source: Gastroenterology - October 5, 2017 Category: Gastroenterology Authors: Omar Y. Mousa, Juan E. Corral, Frank J. Lukens Tags: Clinical Challenges and Images in GI Source Type: research