gistfile1.txt

68 yof cc dysphagia
VS wnl

started 6 mos ago, got worse 2 days ago, husband asked her to come in
pain near xyphoid when swallowing 
started with solids, 3mos ago also liquids
accompanied w/ vomiting
feels like food cant go down
tried cutting food into small pieces to no avail
no dry throat
has trouble breathing when food sticks
happens with every meal
no nausea
stopped eating out of apprehension, still has appetite
10 lbs weight loss
maalox/tums not helping
never happened before
10 year hx of indigestion- HB acid reflux daily
no bleeding or blood in vomit
sulfa drug causes rash
hospitalization: tonsilectomy at 6 years, 2 children
immunization up to date, except pneumonia and flu
no surgery

father rheumatic fever, valve replacement, stent, OA
mother osteoporois
sister osteoporosis, hyperlipidemia
occupation: housewife
married, monogamous 
denies tobacco, rare use of alcohol


PE: epigastric tenderness, no HSM

Labs: upper endoscopy (EGD), CBC, CMP (electrolytes, Ca, Mg, P), liver panel, BUN/Creatinine, barium swallow, chest x-ray, EKG, urinalysis, lipid panel

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x-ray negative for infiltration
normal ekg
urinalysis normal
cbc normal
no CMP panels
lipid normal
thyroid normal

EGD report: esophagitis lower 1/3 of eso. smooth/benign narrowing (dilated to get scope through), gastritis in antrum of stomach

final diagnosis: esophagitis, esophogeal stricture (successfully dilated), gastritis (pantoprazole PPI)