Differential Diagnoses

Differential Diagnoses

According to the patient’s history, among other comorbidities, the patient currently has esophageal cancer. At the time of the current visit, he appears to be primarily presenting with dysphagia, an increase in the metabolic activity of the distal esophagus, an intermittent lesion in the right hemisphere, bilateral lung nodules, and a minor pericardial effusion. Over the past few months, he has considerably dropped weight as well. EGD was performed the year before, but a biopsy revealed no obvious tumor.There were no more symptoms recorded.According to the aforementioned data, esophageal cancer, achalasia, and esophageal stricture are the most likely differential diagnoses (Lancellotta et al., 2020).

Esophageal cancer: Swallowing difficulties and considerable weight loss are the two symptoms of esophageal cancer that occur most frequently. Primary neoplasias of the esophagus can be of two types: squamocellular carcinomas and esophageal adenocarcinomas (Lancellotta et al., 2020). The most accurate way to diagnose esophageal cancer is by gastroscopy. Adjunct methods including chromoendoscopy, simulated chromoendoscopy, magnification endoscopy, and other cutting-edge endoscopic imaging techniques may increase the sensitivity of identifying early-stage cancer. Targeted biopsies can be used to confirm an esophageal cancer diagnosis.

Achalasia: This condition is a persistent disorder that might raise the risk of esophageal cancer. It happens when the esophageal pump fails to push food down, causing it to accumulate in the esophagus and the valve between the stomach, and the esophagus malfunctions. When patients have dysphagia along with other oesophageal complaints and when other conditions have been ruled out by upper endoscopy, achalasia should be suspected as the cause(Mari & Sweis, 2021). A characteristic “bird’s beak” indication, oesophageal dilatation, or a corkscrew look may be seen on a barium esophagogram.

Esophageal Stricture: An esophageal stricture is an abnormal tightness or constriction of the esophagus.As a result, food has a harder time passing through the tube. Upper endoscopy (EGD) and/or a barium swallow study can also be used to diagnose esophageal strictures (Fugazza & Repici, 2021).

References

Fugazza, A., & Repici, A. (2021). Endoscopic Management of Refractory Benign Esophageal Strictures. Dysphagia. https://doi.org/10.1007/s00455-021-10270-y