CASE
An 81-year-old woman with a history of type 2 diabetes mellitus was referred to our hospital with acute chest discomfort and pain during dinner. Cervical computed tomography (CT) images showed the presence of air along the posterior wall of the pharynx, which led to suspicion of pharyngeal emphysema. (Figure 1A, 1B) A sagittal view of CT imaging showed a plate-shaped object attached to the posterior wall of the pharynx (Figure 2). Using a laryngoscope, we found a plate-shaped grilled liver attached to the pharynx wall, and removed it with forceps (Figure 3). After the removal, her symptoms resolved without relapse.
Laryngeal foreign bodies are relatively rare in adults, but can occur in the elderly with few molars or poor coordination of the swallowing. [1] The ”steak house syndrome” refers to esophageal food impaction which can be mistaken as esophageal cancer on CT imaging. [2] In Japan, it is popular to eat plate-shaped grilled meat called “Yakiniku”. (Figure 4) As in this case, when the grilled liver adhered to the pharynx wall, the CT images can resemble cervical emphysema which occur secondary to retropharyngeal abscess or esophageal perforation. It is important to eat slowly and chew thoroughly avoiding laryngeal foreign body.