Article Text

PDF

An unusual cause of acute upper oesophageal obstruction
  1. C G L Hobbs
  1. Laryngeal Research Group, University of Bristol, Churchill Building, Langford House, Bristol BS40 5DU, UK; chris.hobbs{at}doctors.org.uk

    Statistics from Altmetric.com

    A n 85 year old man was admitted with acute dysphagia after eating steak. Apart from a history of hypertension he was otherwise fit and well. Further examination and a standard soft tissue neck radiograph were normal. Although the need for chest radiography was questioned, this actually revealed the cause of the problem: a large thoracic aortic aneurysm (see fig 1).

    A water soluble contrast swallow was performed which showed a meat bolus in the upper oesophagus just above the level of the aortic aneurysm (see fig 2). This was subsequently removed with great care using rigid oesophagoscopy, while a consultant gastroenterologist provided flexible endoscopy cover. The patient was later referred for a cardiothoracic opinion.

    This uncommon cause of acute upper oesophageal obstruction highlights the importance of obtaining a chest radiograph in every case.

    Figure 1

    Posteroanterior chest radiograph on admission.

    Figure 2

    Water soluble contrast swallow.

    View Abstract

    Request permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.