Disease Presentations of the Uvula

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I work in a county hospital ED, and as you already know by that statement, we see an interesting and sometimes unusual patient population. We are also close to the Phoenix airport and main bus station, so we commonly have travelers from all over coming by with their problems and issues, some mundane and other fantastical. We have patients complete a registration form with the name, birthdate, and statement, in their own words, why they are coming today to the ED. We get all sorts of responses, some just a few words, others a long tale of woe. It is sometimes a challenge to figure out why, and why now, even after talking with the patient.

For non-critical patients, those who do not need urgent assessment and treatment, my role as an attending is to discuss the patient with the residents after they have performed the history and physical examination. Now it is my turn to try and make sense of these sometimes confusing complaints. It's my time to cut through the clutter and impart definition to the patient's problem. And sometimes I'm stumped. If there is a complaint localized to a usual body part or an issue claimed by the patient that I have never heard of (a potential range that shirks the older I get — I may not know the specific details of the latest insights, but at least I have heard of it before), I have a stalling response to give me time to marshall my thoughts; I respond to the resident that I must have been absent that day in medical school where this was discussed.

After that admittedly lame attempt at humor, the resident and I can then work through the patient's problem together.

So it once was when patients came in complaining of pain or swelling of that thing that hangs in the back of the throat. I have seen a few cases of uvulitis over the years and read the individual case reports. The authors of this issue have written an excellent review of this unusual problem. After reading this issue, you can say with confidence, I know about this problem.

— J. Stephan Stapczynski, MD, FACEP

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