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Double pathology in a woman with worsening dysphagia

BMJ 2017; 358 doi: (Published 31 August 2017) Cite this as: BMJ 2017;358:j3783
  1. Pazhanivel Mohan, assistant professor,
  2. Kuppusamy Senthamizh Selvan, senior resident
  1. Department of gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, India
  1. Correspondence to Pazhanivel Mohan dr.pazhani{at}

A 58 year old woman had intermittent difficulty swallowing solids for several years. She gave a history of large oral pills getting stuck in the throat. She noticed worsening dysphagia over two months, and it was now persistent and progressive so that she could take only liquids. She had lost weight and on examination was thin and pale. Laboratory tests showed low haemoglobin and iron deficiency. An oesophagogram was taken to evaluate the dysphagia …

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