Postprandial Food and Drooling in a Young Man: What Dx?

August 15, 2013

Food impaction, uncontrollable secretions, progressive dysphagia, and endoscopic findings of concentric rings and longitudinal furrows in the esophagus. The likely diagnosis?

A 24-year-old man presents to the emergency department with a food impaction after eating roast beef for dinner. He is able to control his secretions. He notes that he has had difficulty in swallowing certain solid foods during the past few months and has been eating more slowly than than others. His only medication is ibuprofen as needed. Upper endoscopy demonstrates concentric rings and longitudinal furrows in his esophagus. Which of the following is the most likely diagnosis?


a. Pill-induced esophagitis
b. Erosive esophagitis
c. Peptic stricture
d. Eosinophilic esophagitis
e. Candida esophagitis
 

 Please click here for the answer and discussion.