Dysphagia Lusoria: Using the EndoFLIP
Abstract
REPORT We present a case in which Endo functional luminal imaging probe (FLIP) and chest computed tomography (CT) led to diagnosis of symptomatic dysphagia lusoria. A 48-year-old woman presented with solid food dysphagia, regurgitation, and intermittent globus sensation for 1 year. Her vital signs, physical examination, laboratory test results, abdominal ultrasound, and esophagogastroduodenoscopy were unremarkable. She was started on pantoprazole 40 mg 2 times daily, which initially improved her symptoms. Later on, she developed severe food aversion because of progressive symptoms, which led to unintentional 35 pound weight loss. She was transitioned to lansoprazole 30 mg 2 times daily. Further workup included a barium esophagram, which showed mild esophageal dysmotility in the middle third of the esophagus. Manometry demonstrated a hypercontractile esophagus (mean distal contractile integral of 8,000). The integrated pressures, although normal on supine swallow, were elevated on upright swallows.
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