Absolute dysphagia - An audit of 79 patients

Objectives: To do retrospective analysis of the underlying causes of patients presenting with absolute mechanical dysphagia. Material and Methods: This study was conducted from October 1999 to June 2008, at Department of Medicine, Khyber Teaching Hospital, Peshawar. All the patients who presented with absolute mechanical dysphagia and were fit to undergo upper GI endoscopy were included in the study. Those patients having neurological causes for dysphagia were excluded. A standard proforma was filled regarding the demography of the patients. Nature and the site of the lesion in the oesophagus was recorded and biopsy taken for histopathology. Dysphagia was graded using Cowling's grading system. Results: A total of 79 patients were included in the study, of whom 41 (51.90%) were males and 38 (48.10%) were females. Majority of the patients i.e., 41 (51.89%) patients were in the age range 51 to 70 years. Squamous cell carcinoma was present in 46(58.23%) patients, adenocarcinoma in 23(29.12%) patients and 01(01.26%) patient had Non Hodgkin's Lymphoma. Benign stricture was present in 09 (11.39%) patients. Majority of the patients had malignant stricture in middle third of the oesophagus. Conclusion: Oesophageal carcinoma is the commonest cause of mechanical dysphagia in North of Pakistan, affecting people > 50 years of age with predominance of Squamous cell carcinoma.