Esophageal Food Impaction, a Diagnostic Dilemma Impacto Alimentar Esofágico, um Dilema Diagnóstico

Abstract

Esophageal food bolus impaction is frequently secondary to congenital or acquired esophageal pathology and may constitute the first sign of the disease. We describe a healthy 11-year-old boy, presented with sialorrhea and retrosternal pain developed suddenly while having dinner. An upper gastrointestinal endoscopy detected an impacted piece of meat in the distal third of the esophagus and longitudinal striae in the mucosa. The biopsy revealed esophageal eosinophilia. He was medicated with a proton pump inhibitor, with clinical and histological improvement. The diagnostic differentiation between the main causes of food bolus impaction associated with esophageal eosinophilia, namely eosinophilic esophagitis, gastroesophageal reflux disease and proton pump inhibitor-responsive esophageal eosinophilia, may represent a clinical challenge.

Received: 15/10/2016 - Accepted: 11/12/2017