Navigating Dysphagia Aortica in a 90-Year-Old Patient: A Case Report

Mohamed Omar Hassan,1 Ahmed Shafie Aden,1 Osman Farah Dahir,1 Ahmed Elmi Abdi,1 Ishak Ahmed Abdi,1 Said Abdirahman Ahmed,1 Nasra Mohamud Hilowle,2 Mohamed Osman Omar Jeele3 1Cardiology Department, Mogadishu Somali Türkiye Training and Research Hospital, Mogadishu, Somalia; 2Anesthesia and Reanimation Department, Mogadishu Somali Türkiye Training and Research Hospital, Mogadishu, Somalia; 3Internal Medicine Department, Mogadishu Somali Türkiye Training and Research Hospital, Mogadishu, SomaliaCorrespondence: Mohamed Omar Hassan, Email [email protected]: Dysphagia aortica is an uncommon condition caused by esophageal compression from vascular malformations, often complicating the clinical course in the elderly. This case explores the management of dysphagia aortica in a 90-year-old Somali woman, emphasizing challenges posed by age-related anatomical changes and comorbidities.Case Presentation: The patient presented with chest discomfort, dyspnea, and dysphagia for liquids and solids. Imaging revealed esophageal compression due to ascending aorta dilation. The dysphagia persisted despite pharmacological management, leading to the decision that surgical intervention was too risky. We placed a percutaneous endoscopic gastrostomy (PEG) tube to maintain nutrition, stabilizing her condition and improving her quality of life.Conclusion: This case underscores the importance of individualized, multidisciplinary management in elderly patients with dysphagia aortica. While PEG is a well-established intervention for severe dysphagia, its application in dysphagia aortica, particularly in frail geriatric patients, highlights a crucial, underrecognized approach. This report adds to the limited literature on dysphagia aortica by demonstrating that non-surgical interventions can be effective in maintaining nutrition and quality of life when surgical risks outweigh potential benefits.Keywords: dysphagia aortica, esophageal compression, ascending aorta dilation, percutaneous endoscopic gastrostomy