A patient with systemic sclerosis developed recurrent dysphagia consistently localised to the pharyngo-oesophageal region. This was due to narrowing of the lumen as a result of gross thickening of the pharyngo-oesophageal muscles. Histologically the changes were typical of systemic sclerosis. The lower oesophagus was less involved. Eventually she died of aspiration pneumonia and respiratory arrest.
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