Dysphagia For Liquids Research Articles

Magnetic resonance angiography for diagnosis of right aortic arch with vascular ring

MOTS CLES Arc aortique ; Anneau vasculaire ; Imagerie par resonance A right-sided aortic arch is an aortic arch that crosses over the right main stem bronchus instead of the usual left main stem bronchus. A vascular ring is a malformation where vascular branches encircle the trachea and oesophagus. When the circle around the trachea and oesophagus is incomplete, the malformation is called vascular sling. In most cases, a right-sided aortic arch is present. In a double aortic arch (one of the most common vascular ring malformation patterns), the two arches encircle the trachea and oesophagus. Symptoms of vascular ring, including stridor, wheezing and dysphagia, are due to compression of the trachea or oesophagus. If compression is minimal, vascular rings may be asymptomatic and diagnosed as incidental findings. A 37-year-old man presented with a history of chest discomfort, progressive mild dyspnoea on exertion and intermittent dysphagia for solids and liquids. Chest X-ray showed right aortic arch. Magnetic resonance (MR) angiography showed right aortic arch, separated origin of right carotid and right subclavian arteries, and common origin of left carotid and left subclavian

Respiratory Failure in a 70-Year-Old Veteran

In Western countries the incidence of amyotrophic lateral sclerosis (ALS) is 1.89 per 100,000 per year and the prevalence is 5.2 per 100,000. The incidence of ALS is lower among African, Asian, and Hispanic ethnicities when compared to Caucasians. The mean age of onset for sporadic ALS is about 60 years and there is a slight male predominance (male to female ratio of 1.5 to 1). Approximately two thirds of patients with ALS have the spinal form of the disease with symptoms presenting in the extremities. Patients typically have evidence of both lower motor neuron degeneration (atrophy, weakness, and fasciculations) and upper motor neuron degeneration (spasticity, weakness, and hyperreflexia). Patients with limb onset ALS typically complain of focal muscle weakness and wasting. The symptoms may start either distally or proximally in the upper and/or lower limbs. Gradually spasticity develops in the weakened atrophic limbs, affecting manual dexterity and gait. Patients with bulbar onset ALS typically present with dysarthria and dysphagia for solid or liquids. Limb symptoms can develop simultaneously with bulbar onset. In the vast majority of patients, limb weakness will occur within 1-2 years of bulbar onset ALS symptoms. A case of bulbar and sporadic limb ALS in a 70-year-old veteran, presenting with right diaphragmatic paralysis and respiratory failure, is presented.

A 43-Year-Old Female with Dysphagia: What Is Your Diagnosis by High-Resolution Manometric Finding?

A 43-year-old female was admitted to our hospital with dysphagia for both liquids and solid foods for 2 months. A high-resolution manometry (HRM; version 2.1; Manoscan; Sierra Scientific Instruments Inc., Los Angeles, CA) was performed (Fig. 1). The resting esophagogastric junction (EGJ) pressure in expiration and inspiration were 69 mmHg and 54 mmHg, respectively. The mean integrated relaxation pressure (IRP) with 10 swallows of 5 mL was 40.7 mmHg. This pattern of deglutitive pressure topography was very unswerving during 10 water swallows. The black isobaric contour was set at 30 mmHg in the presented topography. What is your diagnosis with this high-resolution manometry finding? This HRM finding of one swallow shows impaired EGJ relaxation with 57.8 mmHg of IRP, absent peristalsis, and pan-esophageal pressurization from the upper esophageal sphincter (UES) to the EGJ. It was consistent with achalasia and associated esophageal compression based on the Chicago classification of distal esophageal motility disorders.1 Incomplete deglutitive EGJ relaxation with mean IRP and/or mean intrabolus pressure ≥15 mmHg is an essential feature in the diagnosis of achalasia. However, there is no significant pressurization within the body of the esophagus in classic achalasia with impaired EGJ relaxation. In achalasia with esophageal compression as in this case, there is a rapid pan-esophageal pressurization from the UES to the EGJ with >30 mmHg intrabolus pressure in ≥20% of swallows. In spastic achalasia, there is a rapidly propagated pressurization attributable to spastic contractions in which the contractile front velocity is >8 cm/sec in ≥20% of swallows.1,2

“NCCT Scan”—An Alternative Technique for Gorge Carcinoma

Gorge carcinoma or carcinoma of esophagus is one of the most commonly occurring malignancies in developing countries. In these patients, dysphagia for liquids is one of the most common complaints, resulting in unwillingness of the patient to swallow contrast containing liquid. The objective of the study was to find an alternative technique to the currently existing techniques for evaluating esophageal carcinoma. Twenty patients with endoscopically proved cases of esophageal cancer were examined with CT thorax using AIR (negative) as a contrast agent-negative contrast computed tomography scan. Only the mid- and lower third esophageal malignant cases were included in the study. Upper third esophageal malignancy and lesions causing complete obstruction were excluded from the study. All cases were scanned using single-slice Somatom-4 (Siemens). NECT scan was done after intravenous injection of Buscopan. A total of 450-600 ml of air is introduced through a 14G Ryle's tube, both manually and as a continuous flow. IV contrast is given simultaneously, and a CECT scan is done. Multiplanar reconstructions were done in all patients. Significant distension of the normal esophagus was noted. However, very minimal distension of the esophageal lumen was noted at the carcinomatous site--called the "streak sign" as air is seen as a thin streak within the narrowed lumen. In some cases, intraluminal polypoid growth could be seen. No significant complications were noted except for throat irritation. We conclude that usage of air as negative contrast in identifying carcinoma of mid- and lower third esophagus is safe, cost-effective, and feasible and can be used as an alternative technique in patients who are not readily willing to swallow liquid contrast.

Struck Dysphagic

Struck Dysphagic

Giant false aneurysm of innominate artery late after coronary surgery

Fig. 1. (a) CT chest at the time revealed a brachiocephalic trunk aneurysm extending from the origin of the arch of the aorta all the way up to the thoracic inlet area measuring in excess of 8 cm 7 cm 6 cm with evidence of surrounding thrombus and multiple lymph nodes in the preand peri-carinal area with the largest measuring 2.0 cm. (b) The trachea and oesophagus were compressed by the aneurysm and displaced to the left side (Fig. 2). This explained the hoarseness of voice and dysphagia for liquids and solid food in patient. The two working diagnoses were an underlying vasculitic process or a pre-existing aneurysm that became secondarily infected and rapidly expanded as per patient’s blood and urine that grew E. coli.

Upper gastrointestinal symptoms in patients with advanced cancer: relationship to nutritional and performance status

The goals of the study were to determine the relationship of upper gastrointestinal symptoms with nutritional status and to assess their association with performance status in patients with advanced cancer. We studied 143 patients (50 F, 93 M, mean age 68 +/- 11 years, mean body mass index 22.39 +/- 4.3 kg/m(2)). Assessed symptoms were the following: anorexia, nausea, vomiting, dysphagia for solids, dysphagia for liquids, xerostomia, hypogeusia, dysgeusia, hiccup and chewing disturbances. We determined anthropometric parameters, daily energy intake and serum albumin, prealbumin and transferrin. The most common upper gastrointestinal symptoms were xerostomia (73%), anorexia (49%) and chewing disturbances (40%). Fifty-four percent of patients had weight loss greater than 10%. Seventy-three patients (51%) had daily energy intake lower than their resting energy expenditure. Mean serum prealbumin, albumin and transferrin were below normal range. Mean Eastern Cooperative Oncology Group performance status scale was 3.1 +/- 0.49. Symptoms were often strongly correlated, and usually, patients experienced at least three upper gastrointestinal symptoms at the same time. Anorexia, nausea and vomiting were the symptoms mostly correlated with other symptoms. A correlation was found between vomiting and hiccup. Energy intake (EI) was the nutritional parameter mostly affected by upper gastrointestinal symptoms; moreover, EI is the most predictive factor of upper gastrointestinal symptoms, particularly xerostomia, anorexia and dysphagia for solids. Upper gastrointestinal symptoms are linked to nutritional parameters: In particular, energy intake represents the most predictive variable of symptom occurrence. The performance status is not affected by upper gastrointestinal symptoms. A rigorous nutritional assessment and the managing of upper gastrointestinal symptoms are crucial in patients with advanced cancer.

Amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterised by progressive muscular paralysis reflecting degeneration of motor neurones in the primary motor cortex, corticospinal tracts, brainstem and spinal cord. Incidence (average 1.89 per 100,000/year) and prevalence (average 5.2 per100,000) are relatively uniform in Western countries, although foci of higher frequency occur in the Western Pacific. The mean age of onset for sporadic ALS is about 60 years. Overall, there is a slight male prevalence (M:F ratio~1.5:1). Approximately two thirds of patients with typical ALS have a spinal form of the disease (limb onset) and present with symptoms related to focal muscle weakness and wasting, where the symptoms may start either distally or proximally in the upper and lower limbs. Gradually, spasticity may develop in the weakened atrophic limbs, affecting manual dexterity and gait. Patients with bulbar onset ALS usually present with dysarthria and dysphagia for solid or liquids, and limbs symptoms can develop almost simultaneously with bulbar symptoms, and in the vast majority of cases will occur within 1–2 years. Paralysis is progressive and leads to death due to respiratory failure within 2–3 years for bulbar onset cases and 3–5 years for limb onset ALS cases. Most ALS cases are sporadic but 5–10% of cases are familial, and of these 20% have a mutation of the SOD1 gene and about 2–5% have mutations of the TARDBP (TDP-43) gene. Two percent of apparently sporadic patients have SOD1 mutations, and TARDBP mutations also occur in sporadic cases. The diagnosis is based on clinical history, examination, electromyography, and exclusion of 'ALS-mimics' (e.g. cervical spondylotic myelopathies, multifocal motor neuropathy, Kennedy's disease) by appropriate investigations. The pathological hallmarks comprise loss of motor neurones with intraneuronal ubiquitin-immunoreactive inclusions in upper motor neurones and TDP-43 immunoreactive inclusions in degenerating lower motor neurones. Signs of upper motor neurone and lower motor neurone damage not explained by any other disease process are suggestive of ALS. The management of ALS is supportive, palliative, and multidisciplinary. Non-invasive ventilation prolongs survival and improves quality of life. Riluzole is the only drug that has been shown to extend survival.

Evaluation of the response to treatment in patients with idiopathic achalasia by the timed barium esophagogram: results from a randomized clinical trial

To choose which treatment would be most effective for the individual patient with newly diagnosed achalasia is difficult for the tending physician. A diagnostic tool that would allow prediction of the symptomatic and functional response after treatment for achalasia is therefore needed. The timed barium esophagogram (TBE) is a method that allows objective assessment of esophageal emptying, but the value of TBE in the clinical management of achalasia remains to be clarified. The aim of this study was first, to assess the ability of TBE to predict symptoms and treatment failure during post-treatment follow-up. Second, to determine whether esophageal emptying as assessed by TBE differs after treatment with pneumatic dilatation or laparoscopic myotomy. Fifty-one patients with newly diagnosed achalasia were prospectively randomized to pneumatic dilatation (n = 26) or laparoscopic myotomy (n = 25). Evaluation with TBE was performed before (n = 46) and after treatment (n = 43). The median interval between treatment and post-treatment TBE was 6 months, and the median follow-up time after the post-treatment TBE was 18 months. Following therapeutic intervention, TBE parameters did not differ significantly between treatment groups. However, significant correlations were found between the height of the barium column at 1 min and the symptom scores at the end of follow up for 'dysphagia for liquids' (P < 0.05, rho = 0.47), 'chest pain' (P < 0.05, rho = 0.42), and the 'Watson dysphagia score' (P < 0.05, rho = 0.46). Patients with less than 50% improvement in this TBE-parameter (height at 1 min) post-treatment had a 40% risk of treatment failure during follow-up. In summary, pneumatic balloon dilatation and laparoscopic myotomy similarly affected esophageal function as assessed by TBE-emptying. Lack of improvement in barium-column height post-treatment was associated with an increased risk of treatment failure which should motivate close surveillance in order to detect symptomatic recurrence at an early stage.

Laparoscopic diagnosis of pleural mesothelioma presenting with pseudoachalasia

Pseudoachalasia due to pleural mesothelioma is an extremely rare condition. A 70-year-old woman presented with progressive dysphagia for solid and liquids and a mild weight loss. A barium swallow study revealed an esophageal dilatation and a smoothly narrowed esophagogastric junction. An esophageal manometry showed absence of peristalsis. Endoscopy demonstrated an extrinsic stenosis of the distal esophagus with negative biopsies. A marked thickening of the distal esophagus and a right-sided pleural effusion were evident at computed tomography (CT) scan, but cytological examination of the thoracic fluid was negative. Endoscopic ultrasound showed the disappearance of the distal esophageal wall stratification and thickening of the esophageal wall. The patient underwent an explorative laparoscopy. Biopsies of the esophageal muscle were consistent with the diagnosis of epithelioid type pleural mesothelioma. An esophageal stent was placed for palliation of dysphagia. The patient died four months after the diagnosis. This is the first reported case of pleural mesothelioma diagnosed through laparoscopy.

Prevalence of Symptoms and Use of Medication for Gastroesophageal Reflux in an Australian Community

Gastroesophageal reflux disease is common in Western societies, although the prevalence of reflux symptoms in the community is not well described. In this study we determined the prevalence of symptoms of gastroesophageal reflux and other "esophageal" symptoms, and the consumption of medication for reflux in an Australian community. A population sample designed to accurately reflect the characteristics of the population aged 15 years or older in the State of South Australia was studied. Demographic data; symptoms specific to reflux, dysphagia, and abdominal bloating; and the consumption of antireflux medication were determined in a face-to-face interview. The frequency and severity of heartburn and dysphagia were assessed with analog scales. A total of 2,973 people (age range: 15-95 years) were interviewed between September and December 2006. Approximately half experienced the symptom of heartburn; 21.2% experienced heartburn at least once a month, and 12.4% described frequent symptoms of heartburn (at least a few times each week). Of those with heartburn, 25.0% graded it as moderate or severe, 10.9% reported some dysphagia for solid foods, and 6.9% reported dysphagia for liquids. 3.7% described dysphagia for solids at least once a month. Abdominal bloating was reported by 48.2%. 16.9% were taking medications for reflux symptoms (10.1% proton pump inhibitors, 1.2% H2-receptor antagonists, 2.1% simple antacids, 3.4% alternative medications). Heartburn was more common in individuals who consumed medication. There were significant associations between heartburn and bloating, and between heartburn and dysphagia. Symptoms of gastroesophageal reflux and the use of medications to treat such symptoms are very common in the community of South Australia. Nearly 1 in 7 people over the age of 15 consume medication for the treatment of symptoms of reflux.

Defining and Measuring Dysphagia Following Stroke

To continue the development of a quantified, standard method to differentiate individuals with stroke and dysphagia from individuals without dysphagia. Videofluoroscopic swallowing studies (VFSS) were completed on a group of participants with acute stroke (n = 42) and healthy age-matched individuals (n = 25). Calibrated liquid volumes of 3, 5, 10, and 20 ml were administered during the VFSS. Six measures in 3 domains of bolus flow (timing, direction, and clearance) were measured. Values of these measures obtained from the control group were used to classify dysphagia within the participants. The use of a single measure or single liquid volumes to classify dysphagia did not distinguish between healthy adults and individuals following stroke with and without dysphagia. Abnormality on more than 1 measure across multiple volumes appears to be a more robust method in defining dysphagia for liquids. Our findings indicate that the definition of dysphagia is critical in determining whether persons are classified with disordered swallowing. The definition is dependent on materials and measures evaluated. Each measure provides independent aspects to the evaluation. Determining the level of importance of each depends on the purpose of the evaluation.

Dysphagia Due to Unilateral Infarction in the Vascular Territory of the Anterior Insula

We describe a patient who suddenly developed dysphagia for liquids as the sole manifestation of stroke. Magnetic resonance imaging (MRI) revealed a right-sided infarction of the superior part of the anterior insula and a small portion of the adjacent medial frontal operculum. These findings confirm the role of the anterior insula as a critical area in humans with regard to the origin of dysphagia.

Gastrointestinal involvement is frequent in Myotonic Dystrophy type 2

The phenotype of DM2 shows similarities as well as differences to that of Myotonic Dystrophy type 1 (DM1). Gastrointestinal dysfunction is common in DM1 and 25% of the patients consider this to be the most disabling consequence of the disease. Little is known about gastrointestinal involvement in Myotonic Dystrophy type 2 (DM2). The aim of the study was to explore the occurrence and characteristics of gastrointestinal symptoms in patients with DM2. This was compared to symptoms in adult-onset DM1 patients, and to age- and sex-matched healthy controls. Twenty-nine genetically proven DM2 patients filled out two standardized questionnaires about gastrointestinal symptoms; most important outcome measures were answers to questions about dysphagia, abdominal pain, and constipation. The results were compared to those of 29 adult-onset DM1 patients, and to 87 age- and sex-matched healthy controls. Radiological measurement of colon transit time was investigated in 18 DM2 patients. Dysphagia for liquids (38%) and solid food (41%), abdominal pain (62%), and constipation (62%) were all significantly more common among DM2 patients than among healthy controls, and comparable to their occurrence in DM1. Colon transit time was increased in 24% of the DM2 patients. Our results show that gastrointestinal symptoms are highly prevalent in DM2 patients. Gastrointestinal dysfunction may be attributed to any part of the gastrointestinal tract. The results provide new insight into the clinical picture of DM2.

Association between persistent symptoms and long-term quality of life after laparoscopic total fundoplication

Background We investigated which factors are significantly associated with long-term quality of life after laparoscopic total fundoplication in the treatment of gastroesophageal reflux disease. Methods Patients (n = 144) were given a standardized frequency-intensity symptoms questionnaire and the Short-Form 36 Health Survey for quality-of-life evaluation before and after laparoscopic total fundoplication. Results At follow-up evaluation (n = 102), patients had a significant reduction in their symptoms score and no deterioration in quality of life. A significant association with postoperative dysphagia for solids and/or liquids was found in the physical component summary score of the Short-Form 36 administered to patients postoperatively ( P = .003). Conclusions In this study, laparoscopic total fundoplication was a safe and effective surgical treatment for gastroesophageal reflux disease, generally offering an improved long-term quality of life, with the exception of a minority of patients (6 of 102 patients; 5.8%) who experienced persistent severe dysphagia.

A Young Man With a New Diagnosis of Achalasia

d Clinical Scenario A 32-year-old man began to experience food sticking ntermittently in the midchest about 2 years ago. By the time he resents to the gastroenterology clinic, he is complaining of ysphagia at every meal for most hard, solid foods (ie, bread, eats, uncooked vegetables), and for the past 4 months he has oted dysphagia for liquids, especially cold beverages. Once or wice a week, after his large evening meal, he experiences reguritation of recently eaten food with a nonacidic taste. His wife omplains he “gurgles” at night and sometimes awakes her with oughing. He denies chest pain, but does complain of “hearturn,” improving with over-the-counter Prilosec (Proctor & amble, Cincinnati, OH). His weight is down 10 lb. The complaints of dysphagia for both solids and liquids aise the suspicion of achalasia. A barium esophagram shows a ildly dilated esophagus with a column of barium maintained ust below the clavicles with no emptying in the upright posiion over a 5-minute period. The distal esophagus has narowed, with a small amount of barium intermittently streaming nto the stomach. No orderly peristalsis is seen on fluoroscopy. sophageal manometry confirms the diagnosis, finding a high ower esophageal sphincter (LES) pressure (56 mm Hg) with ncomplete relaxation and low-amplitude, simultaneous mirror mage waves after all swallows of water. The patient and his wife return to your office after completng his tests. They have read extensively about achalasia on the nternet. They have many questions: Will I ever be able to eat ormally? Can you cure this disease? What is the best treatent—pneumatic dilation, surgical myotomy, or botulinum oxin injections? What are the side effects and which one will ive me the most relief for a long time?

Is esophageal dysphagia in the extreme elderly (≥80 years) different to dysphagia younger adults? A clinical motility service audit

Dysphagia in elderly patients has major effects on nutrition and quality of life. Although aging itself is associated with changes in esophageal motility, the impact of this on symptoms such as dysphagia is unclear. Data in the extreme elderly are also limited. Symptoms and manometric diagnoses from 23 consecutive older patients (older dysphagia [OD]) >or=80 reporting esophageal dysphagia (12 female, mean age 83 (range 80-93) were compared with those from 23 gender matched younger patients (young dysphagia [YD]) also with dysphagia (mean age 35, range [17-46]). More older patients reported dysphagia as their primary symptom (OD 22/23 vs YD 14/23, P = 0.005). Overall, dysphagia was most common for solids only (OD 16/23 vs YD 15/23) and rare for liquids only (OD 1/23 vs YD 3/23). Dysphagia for both liquids and solids was more frequent in older patients (OD 6/23 vs YD 1/23, P < 0.05). Fewer older patients reported heartburn (OD 3/23 vs YD 14/23, P = 0.001). Manometric diagnoses were generally similar between OD and YD patients with the most common diagnoses being 'nonspecific esophageal motility disorder' (nine each) and 'ineffective peristalsis' (OD = 6, YD = 7). There was a trend for diagnoses related to lower esophageal sphincter failure to be more frequent in younger subjects (OD 1 vs YD 7, P = 0.053). Despite differences in symptom patterns, broad manometric diagnoses in the extreme elderly with dysphagia are similar to younger dysphagia patients. Further studies are required to determine whether this relates to insensitivity in recording or reporting of esophageal manometry (or perceptual differences associated with aging).

THYMOMA, MYASTHENIA GRAVIS, ENCEPHALITIS, AND A NOVEL ANTICYTOPLASMIC NEURONAL ANTIBODY

Thymoma occurs with paraneoplastic myasthenia gravis (MG), but it is rarely associated with encephalitis or dementia. We describe a patient with MG, thymoma, and a prominent cerebellar syndrome, which later generalized to encephalomyelitis. Her serum contained a novel antibody. ### Case report. A 41-year-old woman developed in April 2003 severe periorbital headache, double vision, nausea, and dizziness. Symptoms improved over 2 weeks but recurred 9 weeks after onset. On examination, she had recent memory loss, neck weakness on flexion and extension, horizontal and down-beating nystagmus, diplopia on right lateral and down-gaze, and gait ataxia. In May, an MRI showed abnormally bright signal on the T2-weighted and fluid-attenuated inversion recovery images in the right globus pallidus, substantia nigra, and both thalami. Serial brain MRI during immunosuppression showed disappearance of the abnormal signal as the patient improved. Mild cerebellar atrophy developed radiographically 16 months after symptom onset. Fourteen weeks after onset, she had sudden worsening of true vertigo and dysphagia for solids and liquids. She was hypersomnolent (sleeping > 20 hours daily), but easily aroused. Her speech was explosive/staccato. She required support when ambulating, because of gait ataxia. …

Obstruction, migration and endoscopic removal of a self expandable metal stent placed in the oesophagus. A case report

Aims: At admission patients with oesophageal carcinoma are sometimes at an advanced stage and are no longer candidates for curative surgical resection. For these, radio-chemotherapy and palliative methods are left. Nowadays for patients with high grade stenosis endoscopically placed prostheses are used and self-expandable metal stents are preferred. Case report: We report a case of a 59 years old man who has diabetes mellitus and advanced oesophageal squamous cell carcinoma with dysphagia for solids and liquids. Brachytherapy was started and he was fed via a nasogastric tube. During this treatment bronchopneumonia developed because of aspiration and he became hyperosmotic and comatose. He pulled out the nasogastric tube and afterwards was not able to even swallow beverages. After resolving the hyperosmotic state the oesophageal stenosis was dilated and a self-expandable metal stent was placed. Results: After 10 days of eating semi-solid food, he started to vomit and suffered from hiccups. Gastroscopy was carried out. The stent migrated entirely into the stomach. The lumen of the prosthesis was blocked with food. The stent was grasped with a polypectomy snare pulled out through the oesophagus and mouth. The following day he became anaemic because of bleeding from the tumour. Transfusion and PPI were administered and his general state stabilised. Conclusion: After placement of an oesophageal stent eager eating might entirely occlude the prosthesis. This may play a role in dislodgement of the stent. If an oesophageal stent migrates into the stomach it can be removed easily like other foreign bodies. However, diffuse bleeding from the tumour mass might occurr, even if an overtube was not used.

Retropharyngeal cerebrospinal fluid collection as a cause of postoperative dysphagia after anterior cervical discectomy

Background Transient dysphagia after anterior cervical discectomy is not uncommon. It is usually related to esophageal edema secondary to retraction, mechanical adhesions of the esophagus to the anterior spine, and stretch injuries to nerves involved in the swallowing mechanism. Structurally induced dysphagia, secondary to laceration of the neck viscera or to the presence of retropharyngeal masses, is by far less frequent, and it does not usually improve over time. Case Description The authors present the case of a 36-year-old woman who complained of severe dysphagia both for solids and liquids after C4 through C5 anterior discectomy and fusion, complicated by a millimetric dural tear of the anterior thecal sac. Postoperative neuroimaging revealed retropharyngeal fluid collection, extending in front of the vertebral bodies of C3, C4, and C5, exerting a mass effect on the posterior wall of the pharynx. Taking into account both the MRI aspect of the collection and the dramatic improvement of symptoms after lumbar punctures, we conducted a diagnosis of CSF collection in continuity with the subarachnoid space. The dysphagia and the CSF collection resolved with conservative therapy (bed rest and 3 lumbar punctures). Conclusion To the best of our knowledge, such a complication has never been described before in the literature. It should be included in the differential diagnosis of patients with postoperative dysphagia lasting more than 48 hours.