An 80-year-old woman with a medical history of solid dysphagia presented to the clinic with regurgitation of solids and liquids after eating sweet potatoes for the past 48 hours. Esophagogastroduodenoscopy (EGD) under moderate sedation was performed and showed complete obstruction of the esophageal lumen by potato debris throughout (Figure 1). Multiple attempts were made to remove the food burden through an overtube with retrieval net and forceps without significant progress. The following day, a repeat EGD was performed under general anesthesia. Initially, a 15-mm biliary extraction balloon was passed through the food bolus, inflated and pulled back, with partial removal of the potato through the overtube (Figure 2). Next, suction tubing was inserted alongside a stricture scope to provide efficient clearance of the debris under direct visualization. Water irrigation with suction was used for residual potato debris without resultant mucosal injury (Figure 3). Several hours after the procedure, the patient demonstrated tolerance of a solid diet and was discharged the same day. A follow-up EGD several weeks later revealed normal esophageal biopsies and evidence of presbyesophagus which was thought to be the likely etiology of the food impaction. This case demonstrates a novel approach to treating esophageal food bolus of an uncommon etiology. The use of suction tubing under direct visualization appears to be safe and effective for the removal of small food debris.
Author contributions: A. Mertz, Z. Junga, S. Ordway wrote the manuscript. A. Tritsch approved the final version. A. Mertz is the article guarantor.
Financial disclosure: None to report.
Previous presentation: This case was presented at the American College of Gastroenterology Annual Scientific Meeting; October 5-10, 2018; Philadelphia, Pennsylvania.
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