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Complete oesophageal food bolus obstruction — SCE Acute Medicine MCQ

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HardGastroenterology and hepatologyComplete oesophageal food bolus obstructionSCE Acute Medicine

A 38-year-old man presents 4 hours after eating steak with complete dysphagia and drooling. He has asthma and intermittent solid-food dysphagia for several years. He is haemodynamically stable and chest radiograph shows no perforation. What is the most appropriate next step in management?

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Correct answer: A — Arrange urgent upper GI endoscopy for food bolus removal

Complete oesophageal obstruction with drooling requires urgent endoscopic removal, particularly with a history suggesting eosinophilic oesophagitis. Outpatient endoscopy is unsafe when the patient cannot handle secretions. Blind instrumentation risks perforation and should be avoided.

Reference: https://www.bsg.org.uk/clinical-resource/#acute-medicine-order-85-1