87-year-old woman with painful swallowing.

An 87-year-old woman presented to her local emergency department with symptoms of acute-onset odynophagia with a sense of fullness in her throat. She was suspected to have an esophageal food impaction. Conservative management was unsuccessful, and she underwent attempted endoscopic removal of the food impaction. The procedure revealed a food impaction at the distal half of the esophagus, with probable tissue erosion, stenosis, and bleeding into the esophageal lumen. Attempts at removal of the food bolus were unsuccessful. During the procedure, she was transiently hypertensive with systolic blood pressures greater than 230 mm Hg and had a self-limited episode of supraventricular tachycardia. She was urgently transferred to Mayo Clinic in Rochester, MN, for further evaluation and management.