Maneuvering With Difficulty Around Jagged Edges: A Unique Case of Mixed Dysphagia Causing Recurrent Aspiration Pneumonia: Page 3 of 3

September 15, 2011

Take-Home Message

Our case report highlights several practical pearls when managing dysphagia and aspiration pneumonia in the elderly, including the following:

1. Do not take recurrent aspiration pneumonia lightly. It is associated with high rates of mortality and morbidity; thus, the cause of recurrent aspiration should be actively pursued.

2. Do not attribute swallowing difficulties solely to the most obvious cause; rather, consider possible concomitant etiologies, such as the comorbid conditions discussed in this article.

3. Do not dismiss cervical radiological changes common to elderly individuals as age-related and therefore innocuous; when in doubt, use videofluoroscopy to exclude mechanical obstruction of the oropharynx.

4. Use a multidisciplinary approach. This approach is valuable in managing acutely ill elderly patients, as it includes specialists such as the speech-language pathologist, who can play an important role in diagnosing and managing recurrent aspiration pneumonia.


The authors report no relevant financial relationships.

Dr. Bellia is resident specialist of geriatrics, and Dr. Vella is consultant geriatrician, Department of Geriatrics, Karin Grech Rehabilitation Hospital, Pietà, Malta.



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