THÔNG TIN TÀI LIỆU
Thyroid dysfunction Polyhydramnios Fetal irradiation Food allergy Birth history Birth trauma Hypoxia Endotracheal intubation or resuscitation Cough/gag/cyanosis/fatigue/stridor/irritability with feeding Feeding times greater than 30 Respiratory distress associated with feeding Vomiting or regurgitation Level of alertness Weight gain or failure to thrive Nasal regurgitation Refusal to eat age-appropriate foods Recurrent pneumonias Family history of neuromuscular disease Provided oral intake is not contraindicated by an expected procedure or intervention, observation of a typical feeding, given by a parent or primary caregiver, may help elucidate the cause of dysphagia The manner of presentation of food to the patient, the consistency and amount given, patient position, duration of feeding, regurgitation (oral or nasal), agitation or behavior change, or the development of respiratory symptoms may further guide the diagnostic evaluation Patients with upper airway obstruction may have an exacerbation of symptoms when attempting to drink Patients with lesions such as tracheoesophageal fistula, vascular rings, or esophageal obstruction may begin coughing and choking soon after drinking without any initial difficulty However, esophageal disorders such as extrinsic compression, strictures, tumors, or altered motility commonly are clinically silent and typically require use of radiographic or direct visual techniques for diagnosis Evaluation of the stable dysphagic patient may proceed on the basis of age and acute versus chronic onset of symptom development ( Fig 56.2 ) The neonate and young infant will require evaluation techniques and consideration of the agerelated differential diagnoses outlined in Table 56.2 , whereas the older child with
Ngày đăng: 22/10/2022, 12:13
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