Gastroenterology
Case 41: A Man with Dysphagia and Weight Loss
CASE
An 88‐year‐old man presents to your hospital with 6 weeks of progressive dysphagia to solids. He has lost 9 kg in weight. He has ischaemic heart disease having previously had coronary artery by‐pass surgery and currently uses GTN spray in anticipation of angina before walking to his corner shop for the morning newspaper. He no longer smokes. He lives with his wife who has cognitive impairment. Their only daughter now lives in Australia.
On examination he looks emaciated and dehydrated. He has no palpable lymphadenopathy. Abdominal examination reveals a small but palpable aortic aneurysm but is otherwise unremarkable.
An open‐access endoscopy has demonstrated the patient to have a malignant oesophageal stricture at 25 cm from the incisors. The stricture precluded completion of the examination and a biopsy taken at the time of the procedure has shown squamous carcinoma.
QUESTION 1
Your score this session: 0 of 0
His further management should include: