Methods
Chest and spine x-rays were performed and showed no abnormalities. Laboratory tests were all within normal limits. An urgent gastroscopy was subsequently conducted, revealing a narrowed esophagus at 30 cm from the incisors with linear furrows and rings, above which a piece of meat was lodged (Figure 1). The impacted food was removed in pieces using rat tooth grasping forceps. The endoscopist attempted to pass through the distal esophagus with an adult gastroscope without success, necessitating the use of a pediatric endoscope which could traverse the narrowed esophagus successfully. These findings were indicative of steakhouse syndrome.
Following the gastroscopy, esophageal biopsies were taken and showed more than 15 eosinophils per high-power field, confirming a diagnosis of eosinophilic esophagitis. Subsequently, the patient was prescribed omeprazole 20 mg twice daily and fluticasone 250 mcg 2 puffs orally three times daily 30 minutes before meals. He was also advised to follow a six-food elimination diet.