Endoscopic Palliation of Malignant Dysphagia

Richard C.K. Wong, M.B., B.S., and Jacques Van Dam, M.D., Ph.D.

N Engl J Med 1996; 335:475August 15, 1996

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Figure 1 A 90-year-old woman presented with a three-month history of progressive dysphagia, postprandial vomiting, and weight loss. Barium contrast studies of the upper gastrointestinal tract showed an irregular narrowing in the midesophagus (Panel A, arrows). On the day upper gastrointestinal endoscopy was performed, the patient was unable to swallow her own saliva. Endoscopy showed a friable mass that almost totally obstructed the lumen of the midesophagus (Panel B, arrow). Biopsies disclosed invasive squamous-cell carcinoma. An expandable metallic esophageal endoprosthesis was endoscopically deployed (Panel C). A subsequent lateral chest x-ray film demonstrated a fully expanded endoprosthesis measuring 60 mm by 20 mm (Panel D, arrows). At follow-up nine months later, the patient was able to swallow liquids and pureed foods and was carrying on her usual daily activities.

Kim Eagle, M.D.

Richard C.K. Wong, M.B., B.S.
Jacques Van Dam, M.D., Ph.D.
Brigham and Women's Hospital, Boston, MA 02115

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