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J Korean Dysphagia Soc 2020; 10(1): 134-137

Published online January 30, 2020

Copyright © The Korean Dysphagia Society.

Esophagostomy as an Alternative to Gastrostomy for Dysphagia in Muscular Dystrophy: A Case Report

Jin Seok Bae, M.D., Jong Keun Kim, M.D., Jong Youb Lim, M.D., Kang Jae Jung, M.D., Hyo Sik Park, M.D.

Department of Rehabilitation Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea

Abstract

Many people with muscular dystrophy develop dysphagia that can result in an inability to use the oral route in severe cases. In such cases, an alternative feeding method is selected, including a nasogastric tube or a gastrostomy. This case report describes a 40-year-old man with muscular dystrophy who was managed for swallowing difficulty and respiratory failure. Oromotor muscle weakness caused prolonged mealtimes, difficulty with swallowing a solid- form diet, aspiration signs, and weight loss. Consequently, an alternative feeding method was required. An abdominal radiograph showed massive aerophagia, and the transverse colon was located over the stomach. As a result, the colon interfered with the puncture route, which could lead to colon perforation. Therefore, cervical esophagostomy was selected, where the patient obtained nutrition through a cervical esophagostomy tube. This case showed that when gastrostomy cannot be performed due to aerophagia, cervical esophagostomy can successfully support nutrition for the mid to long-term in muscular dystrophy patients.

Keywords: Muscular dystrophy, Dysphagia, Enteral nutrition, Cervical esophagostomy, Gastrostomy

Article

Case Report

J Korean Dysphagia Soc 2020; 10(1): 134-137

Published online January 30, 2020

Copyright © The Korean Dysphagia Society.

Esophagostomy as an Alternative to Gastrostomy for Dysphagia in Muscular Dystrophy: A Case Report

Jin Seok Bae, M.D., Jong Keun Kim, M.D., Jong Youb Lim, M.D., Kang Jae Jung, M.D., Hyo Sik Park, M.D.

Department of Rehabilitation Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea

Abstract

Many people with muscular dystrophy develop dysphagia that can result in an inability to use the oral route in severe cases. In such cases, an alternative feeding method is selected, including a nasogastric tube or a gastrostomy. This case report describes a 40-year-old man with muscular dystrophy who was managed for swallowing difficulty and respiratory failure. Oromotor muscle weakness caused prolonged mealtimes, difficulty with swallowing a solid- form diet, aspiration signs, and weight loss. Consequently, an alternative feeding method was required. An abdominal radiograph showed massive aerophagia, and the transverse colon was located over the stomach. As a result, the colon interfered with the puncture route, which could lead to colon perforation. Therefore, cervical esophagostomy was selected, where the patient obtained nutrition through a cervical esophagostomy tube. This case showed that when gastrostomy cannot be performed due to aerophagia, cervical esophagostomy can successfully support nutrition for the mid to long-term in muscular dystrophy patients.

Keywords: Muscular dystrophy, Dysphagia, Enteral nutrition, Cervical esophagostomy, Gastrostomy

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