Case: 151

Cricopharyngeal Bar

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History: 85 yo male with difficulty swallowing
Solution: A cricopharyngeal bar is a posterior impression in the cervical esophagus which is caused by hypertrophy and/or fibrosis of the cricopharyngeus muscle. It most frequently occurs in the elderly. It can be seen transiently in up to 5% of patients without symptoms, but when it persists and is severe, it can be an important cause of dysphagia. Treatment can involve botox injection, dilatation and cricopharyngeal myotomy. Imaging findings in this case are characteristic.

Radiograph Images

Questions

Treatment options include all of the following EXCEPT:
  • Myotomy
  • Dilatation
  • Nothing
  • Botox injection
  • Amyl nitrate
This process is most likely to be malignant.
False
There are actually two diagnoses that can be made on these images. For full credit, give both.
Cricopharyngeal bar and pharyngeal pouch