Distal esophageal meat impaction. (Esophagoscopy Clinic).

A 54-year-old man who had been admitted to the hospital for acute pancreatitis 2 weeks earlier developed severe emesis, dysphagia, and an inability to tolerate food or liquid by mouth. He began to experience these symptoms 30 minutes after he had eaten a steak. He had no previous history of dysphagia, acid reflux, or regurgitation.

Transnasal esophagoscopy revealed the presence of a complete impaction of meat immediately above the gastroesophageal junction, 38 cm from the nasal vestibule (figure, A). The bolus of food was gently advanced into the stomach with the tip of the esophagoscope, and the patient experienced immediate relief of all symptoms. After disimpaction of the bolus, a small hiatal hernia was evident (figure, B).