Pediatric emergency medicine trisk 1099 1099
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TABLE 56.3
LIFE-THREATENING CAUSES OF DYSPHAGIA
Foreign-body aspiration/ingestion
Anaphylaxis
Tracheoesophageal fistula
Upper airway obstruction
Traumatic esophageal perforation
Epiglottitis
Retropharyngeal abscess
Botulism
Tetanus
Polio
Diphtheria
Central nervous system infection/abscess
Stevens–Johnson syndrome
Corrosive ingestion
Laryngeal paralysis
Life-threatening causes of dysphagia may involve airway compromise, serious
local or systemic infection, and inflammatory disease ( Table 56.3 ). The
newborn may have a congenital anatomic abnormality, such as tracheoesophageal
fistula, with aspiration of swallowed fluid into the lungs, or may have traumatic
injury to the upper airway and esophagus from iatrogenic instrumentation in the
delivery room. The older child may have a foreign body in the airway or
esophagus, with the possibility of complete airway obstruction (see Chapter 8
Airway ). Anaphylaxis or other allergic and infectious processes may present with
dysphagia and can threaten airway integrity. These include epiglottitis,
retropharyngeal abscess, Stevens–Johnson syndrome, and central nervous system
infections.
