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Intractable vomiting: diagnostic clues in plain neck films
  1. Hope Olivia Ward,
  2. David Alao
  1. Department of Emergency Medicine, Derriford Hospital, Plymouth, Devon, UK
  1. Correspondence to Dr Hope Olivia Ward, Department of Emergency Medicine. Derriford Hospital, Derriford Road, Plymouth, Devon PL6 8DH, UK; hope.ward{at}nhs.net

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Clinical introduction

An 89-year-old man with dementia presented to the emergency department with a 3-day history of sharp central chest pain and vomiting. His carer said he had been unable to keep anything down since he had a steak pie 3 days earlier. His chest X-ray was normal. A soft tissue X-ray of the neck was done (figure 1).

Figure 1

X-ray of neck soft tissues.

Question

What is the abnormality?

  1. Epiglottitis

  2. Oesophageal food bolus

  3. Foreign …

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