Most esophageal obstruction develops slowly and is incomplete when patients first seek care, typically for difficulty swallowing solids. However, sometimes complete esophageal obstruction develops suddenly because of an impacted esophageal foreign body or food bolus.
(See also Overview of Esophageal and Swallowing Disorders.)
Obstruction may have intrinsic or extrinsic causes.
Intrinsic obstruction may be caused by
Esophageal tumors (benign esophageal tumors or esophageal cancer)
Strictures caused by gastroesophageal reflux, eosinophilic esophagitis, or, rarely, caustic ingestion
Extrinsic obstruction may be caused by compression resulting from
An enlarged left atrium
An aberrant subclavian artery (termed dysphagia lusoria)
A substernal thyroid gland
Cervical bony exostosis
For evaluation of potential esophageal obstruction, see Dysphagia.
Treatment of obstruction is directed at the specific cause. Emergent upper endoscopy is essential for patients with complete obstruction.
