A teenage female patient was admitted to the hospital with severe dysphagia after ingesting a large piece of meat. Imaging revealed a total blockage of the mid-thoracic esophagus. The patient underwent urgent esophagoscopy under general anesthesia to remove the bolus in pieces. The patient recovered well and was discharged the next day. Food bolus impactions usually resolve on their own but medical attention is needed if symptoms persist or there is chest discomfort. Patients experience squeezing chest pain but can still talk and cough, unlike choking where breathing is interrupted.

1. ‫الرحيم‬ ‫الرحمن‬ ‫هللا‬ ‫بسم‬
Food Bolus Impaction
with Severe Dysphagia
Prof. Abdulsalam Y Taha
College of Medicine
University of Sulaimani
2022
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2. The Case
 A teenager female patient was
admitted to Sulaymaniyah Teaching
Hospital, Sulaymaniyah, Iraq with
severe dysphagia following
ingestion of a big meat bolus.
Contrast esophagography revealed
a total obstruction of the mid-
thoracic esophagus.
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4. The Case…
 The patient was then subjected to
urgent rigid esophagoscopy under
general anesthesia (GA), during
which a big meat bolus was
removed in pieces. The patient had
a smooth postoperative recovery
and was discharged home the next
day in a good health.
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7. Comment
 “Food bolus impactions are acute events
that, for the most part, are immediately
recognized by the patient. Most food
bolus impactions resolve without
intervention, either by moving forward to
the stomach or by the patient
regurgitating the ingested contents.
When symptoms of obstruction persist
and/or are accompanied by substantial
chest discomfort, patients will seek
medical attention”.
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8. Comment…
 “Patients primarily experience a sensation
of squeezing in the chest, which can be
frightening as it is difficult to discriminate
from heart attack pain. However, food
bolus impaction is additionally associated
with sialorrhea or excessive salivation,
which accompanies esophageal
obstruction. Patients are also unable to eat
or drink anything further when
experiencing an impaction”.
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9. Comment…
 “It is important to differentiate
impaction from choking. Patients
with food bolus impaction do not
have any interruption of breathing.
They can talk and they can cough,
whereas a person who is truly
choking is unable to do any of these
things”.
 (Ginsberg GG. Food bolus impaction. Gastroenterol
Hepatol (N Y). 2007 Feb;3(2):85-6. PMID: 21960815;
PMCID: PMC3099357).
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