COVERT DYSPHAGIA IN THE MENTALLY-HANDICAPPED - 2 CASE-REPORTS AND A REVIEW OF PUBLISHED LITERATURE

Mentally handicapped patients with esophageal pathology may present a diagnostic challenge, as they may not complain of any specific symptom s or be able to give a clear history of either dysphagia or odynophagi a. This paper reports 2 such patients who recently presented to the Ro yal Wolverhampton Hospitals. In the first case, upper gastrointestinal endoscopy under general anesthesia enabled both the identification an d removal of a large esophageal foreign body, In the second case, repe ated upper gastrointestinal endoscopy facilitated both the identificat ion and nonsurgical management of a paraesophageal abscess.