This 18 year old girl could not swallow food or drink after there was a lodgement of chicken in her oesophagus.
The bolus was removed endoscopically and a condition known as Eosinophilic Oesophagitis (EOE) diagnosed based on typical endoscopic and biopsy findings.
Eosinophilic Oesophagitis should be considered in adults with a history of food impaction, with persistent dysphagia, or with gastro-oesophageal reflux disease that fails to respond to medical therapy.
Making a diagnosis of eosinophilic oesophagitis requires the presence of both symptoms and histologic findings on biopsies performed during endoscopy.
The patient in this case did very well with medications.
Such medications include Proton Pump inhibitors, and swallowed topical corticosteroids.
Because of the strong association of eosinophilic oesophagitis with allergies, it is often also prudent to consider evaluation by an allergist or immunologist, as the results of the evaluation may have treatment implications in the form of exclusion diets where food allergies are detected.
Occasionally, the bolus obstruction in EOE is due to a resultant oesophageal stricture, which responds well to endoscopic dilation.
