"Double dysphagia" in an older female

The case illustrates the presentation of dysphagia at two different sites in an older female. Evaluation confirmed the presence of two etiologies, namely, extrinsic compression in the upper esophagus from osteophytes in the cervical spine and an intrinsic basis in the lower esophagus from a mucosal ring. Conservative management produced good results. Dysphagia in older adults does not occur on the basis of aging alone and warrants evaluation; it may rarely result from more than one cause.