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  1. Student
  2. A patient with dysphagia
  3. A patient with dysphagia
Student Education

A patient with dysphagia

BMJ 2006; 332 doi: https://doi.org/10.1136/sbmj.0606229 (Published 01 June 2006) Cite this as: BMJ 2006;332:0606229
  1. Rishi Singhal, senior house officer1,
  2. Norzin Angmo, house officer in medicine2,
  3. Chris Ayshford, specialist registrar3,
  4. Marcelle Macnamara, consultant3
  1. 1Department of Ear, Nose, and Throat Surgery, Birmingham Heartlands and Solihull NHS Trust, Birmingham
  2. 2University Hospital Aintree, Liverpool
  3. 3Department of Ear, Nose, and Throat Surgery, Birmingham Heartlands and Solihull NHS Trust

A 19 year old man presented to the accident and emergency department with acute onset inability to swallow and a feeling of a lump in his throat after having a meal. On examination he was distressed and was drooling saliva. The patient showed marked dysphagia when asked to take sips of water.

A lateral neck radiograph was taken to confirm the diagnosis (figure).

Lateral radiograph of the neck

Questions

  1. What is the diagnosis?

  2. What are the classic features of this on a radiograph?

  3. What is the management?

Answers

  1. The diagnosis is a foreign body at the level of the cricopharynx. The lateral radiograph of the soft tissues of the neck shows soft tissue thickening at the cricopharynx, representing a food bolus (A), and marked presence of air in the upper oesophagus inferior to the food bolus (B).

  2. A lateral soft tissue radiograph of a foreign …

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