November 2017 Critical Care Case of the Month

Stephanie Fountain, MD

Pulmonary and Critical Care Medicine

Banner University Medical Center Phoenix

Phoenix, AZ USA

History of Present Illness

A 56-year-old man presented with “food stuck in throat” since eating steak 18 hours prior to presentation. He is unable to eat or drink and has a sore throat. He is able to speak but has a “hoarse voice.” He denied drooling.

Past Medical History, Family History, and Social History

• He described himself as “healthy” and had not sought medical care in years.
• Former smoker but quit 2 years ago.
• He uses alcohol daily.
• He denied illicit drug use.

Physical Exam

• Afebrile, blood pressure 137/74 mm HG, heart rate 74 beats/min, SpO2 98% on room air.
• Physical exam was normal

Which of the following should be done next? (Click on the correct answer to proceed to the second of six pages)

1. Esophagogastroduodenoscopy (EGD)
2. Papain (Adolph’s Meat Tenderizer®) administration
3. Tracheostomy
4. 1 and 3
5. All of the above

Cite as: Fountain S. November 2017 critical care case of the month. Southwest J Pulm Crit Care. 2017;15(5):191-8. doi: https://doi.org/10.13175/swjpcc130-17 PDF