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Here we have a 46-year-old gentleman

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who comes in with a sensation of something stuck in his throat by clinical history.

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And we don't have an X-ray for this case, but we do have a CT.

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So this is another opportunity.

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But we do have the scout view.

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So again, encourage everyone to take a look at the scout views,

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because there's oftentimes information that you'll glean there.

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So taking a look at the frontal scout, it's really hard to see through the soft

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tissues of the neck, but we do have a lateral here where we can

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see nicely the airway, their prevertebral soft tissues.

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And if we window and level, we can begin to see the soft tissues of the neck.

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And at least on the view of the scout,

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it wasn't apparent that there was any foreign body that we could see.

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But fortunately, we have the CT for a lot better information.

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So let's take a look at that.

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And the contrast enhanced axial images through the neck are available here.

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I've really cone down to the lower airway just so we can be efficient.

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Obviously, we won't take a look at all of the structures.

1:03

We'll go back and just do a fly-through

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to make sure that we're not missing anything.

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And what we can see here is that in terms

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of the trachea, we're not seeing any abnormalities.

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It is helpful to be able to window

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into lung windows, just make sure you're not missing anything.

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So we'll take a look at the airway

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and at least from an aspiration perspective, it doesn't look like there's

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anything that we see throughout the entire spectrum.

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So we go back through into soft tissues

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to make sure there's not anything that would explain the patient's symptomology.

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And so again, if we begin to look through and follow through the esophagus,

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we can see that there's some thickening here, some gas.

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And here at the 3 o'clock position, we have high attenuation density that we

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don't expect to see inside of the esophagus.

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The esophagus here continues,

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and so we don't see any gas around the esophagus.

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I don't think there's any evidence of esophageal perforation,

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but we do have a foreign body that's sitting here in the proximal esophagus.

2:09

The coronal views are helpful, but I really find the sagittals most helpful.

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And as we move through the sagittal images, what we see right here is

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that same radio paved foreign body that we saw on the axial images here.

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So this is the same area that correlates sitting here.

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So it's helpful when we're looking at foreign bodies to be able to describe

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them so that people can correlate with what may have taken place.

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And so this is high density, so it's very similar to bone.

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If we compare the two attenuations,

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we can measure it as well, get a sense of how big the structure is.

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So it measures about 2.2cm in the proximal esophagus, and as it turns out and kind

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of really pressing the patient for more information.

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He experienced this sensation after kind

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of thinking that he may have swallowed a chicken bone.

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So in terms of the density,

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it certainly does measure osseous attenuation and correlates

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with a foreign body in the esophagus,

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eating a chicken bone. Probably not recommended,

3:14

just eat the meat, enjoy it.

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And this is a case of an Esophageal foreign body.