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Korean J Neurogastroenterol Motil. 2005 Dec;11(2):166-169. Korean. Case Report.
Yang SY , Lee OY , Han SH , Jun DW , Roh BJ , Yoon CO , Lee HL , Yoon BC , Choi HS , Hahm JS , Lee MH , Lee DH , Kee CS .
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.

Acute esophageal obstruction caused by the impaction of a large bolus of food has been called the 'steakhouse syndrome'. Esophageal stenosis is usually found in adults suffering with steakhouse syndrome, but occasionally the syndrome occurs in the absence of any underlying organic abnormality. A 71-year-old male patient had complained of swallowing difficulty after ingesting meat two days previously. We performed endoscopy and found a meat bolus at 30 cm from the incisors, and we so removed the meat with a basket. No pathologic findings were observed endoscopically after the removal of the esophageal meat bolus. The esophageal manometry showed segmental, high amplitude esophageal pressure at the lower esophagus with normal peristalsis. We performed endoscopic ultrasonography with a high frequency catheter and we found thickening of the lower esophageal muscle layer. This case shows that nutcracker esophagus may be the cause of esophageal foreign body impaction and thickening of muscle layer may be associated with the symptom.

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