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.