CLINICAL AND RADIOLOGIC EVALUATION REVEALS NIGH PREVALENCE OF ABNORMALITIES IN YOUNG-ADULTS WITH DYSPHAGIA

The purpose of this study was to retrospectively evaluate the radiolog ic findings in young adults with dysphagia undergoing barium swallow a nd to compare these with the final clinical diagnosis. Clinical histor y, barium swallow, endoscopy (21 patients), manometry (18 patients), 2 4 h pH monitoring (I patients), and outcome of treatments were studied and compared in 43 patients aged 14-30 years (mean 24 years). There w ere 26 men and 17 women. Duration of symptoms varied between 2 weeks a nd 22 years and included globus (n = 22), obstruction (n = 31), water brash (n = 6), classic reflux symptoms (n = 10), atypical reflux sympt oms (n = 9), slow eating (n = 6), and vomiting (n = 11). The final dia gnosis was achalasia (n = 2), arteria lusoria (n 1), esophagitis (n = 1), esophageal dysfunction (n = 11), esophageal stricture (n = 5), gas troesophageal reflux disease (n = 8), and pharyngeal dysfunction (n = 2). Thirteen patients were assessed to be normal. The result of the ba rium swallow was in agreement with the final diagnosis in all but 3 pa tients who were assessed as normal, and the final diagnosis was esopha gitis (n = 1), dysmotility (n = I)? and reflux disease (n = 1). Anatom ic and functional abnormalities are common in young adults with dyspha gia, Barium swallow reveals the explanation of the symptoms in 70% of such patients. Radiology therefore should be the method of choice for the investigation of dysphagic young adults.