CC: trouble swallowing solids, food impaction
ID: 35-year-old male with asthma and intermittent difficulty in swallowing solids for 2 years presents with food impaction after eating a chicken sandwich. He had a negative review of systems. Exam showed no evidence of oropharyngeal dysfunction nor cranial nerve deficits. Patient had an elevated absolute eosinophil count of 1000 cells/uL but otherwise normal labs. EGD showed normal esophageal mucosa but biopsy results of the distal esophagus demonstrated increased intramucosal eosinophils (>20/HPF) consistent with eosinophilic esophagitis.
If odynophagia occurs with dysphagia, the differential changes:
Pearls from Morning Report: