0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Special Feature |

Picture of the Month FREE

Cyril Engmann, MBBS; Melinda Kakish, MD; Robert M. Truding, MD, PhD
[+] Author Affiliations

Section Editor: Walter W. Tunnessen, MD


Arch Pediatr Adolesc Med. 2001;155(6):729-730. doi:10.1001/archpedi.155.6.729.
Text Size: A A A
Published online

A 15-YEAR-OLD GIRL had a 3-day history of mild nausea and pain on swallowing. The pain began gradually immediately after swallowing and was characterized as a sharp and stabbing, localized near the left scapula. Swallowing liquids was more painful than swallowing solid foods. The pain was not present between swallows. She had eaten and drunk little during the past 2 days because of the pain and nausea. A 4-lb weight loss during the past week was confirmed. Standing upright resulted in dizziness.

Her medical history was notable for exercise-induced asthma. Smoking, drug use, and sexual activity were denied. Four days before presentation, after excision of an ingrown toenail, cephalexin (250-mg capsules, orally, every 6 hours) was prescribed. On further questioning, she recalled taking this medication with a small amount of fluid the day before symptoms began, during which time she encountered difficulty swallowing the capsule.

On physical examination the patient was without fever and showed mild signs of dehydration. The findings on examination were otherwise unremarkable. Results of a barium swallow were normal, but endoscopic examination revealed abnormal findings at the level of the mid esophagus (Figure 1).

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
JAMAevidence.com