A 43-year-old man presented to the emergency department with the sudden onset of dysphagia to both solids and liquids after eating a small bony fish earlier that evening. He was also initially unable to swallow saliva. He denied any dyspnea or cough but described a sensation of having something stuck in his throat. He was generally fit and well but was known to have anxiety attacks, for which β-blockers had been prescribed.
The findings of clinical examination of the neck and fiberoptic examination of the larynx and pharynx were unremarkable. A lateral soft-tissue radiograph of the neck was obtained (Figure 1). The dysphagia persisted, and the patient subsequently underwent a contrast swallow study (Figure 2) and a computed tomographic (CT) scan (Figure 3) of the neck.
Gulati A, Sunkaraneni VS, Proctor RD, Hellier WP. Radiology Quiz Case 1. Arch Otolaryngol Head Neck Surg. 2011;137(5):522. doi:10.1001/archoto.2011.64-a