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Obstructive Disorders of the Esophagus

by Michael C. DiMarino, MD

Most esophageal obstruction develops slowly and is incomplete when patients first seek care, typically for difficulty swallowing solids. However, sometimes complete esophageal obstruction develops suddenly because of an impacted foreign body or food bolus (see Esophageal foreign bodies).

Obstruction may have intrinsic or extrinsic causes.

Intrinsic obstruction may be caused by

  • Esophageal tumors (benign or malignant)

  • Lower esophageal rings (see Lower Esophageal Ring)

  • Esophageal webs (see Esophageal Web)

  • Strictures caused by gastroesophageal reflux or, rarely, caustic ingestion

Extrinsic obstruction may be caused by compression resulting from

  • An enlarged left atrium

  • An aortic aneurysm

  • An aberrant subclavian artery (termed dysphagia lusoria—see Dysphagia Lusoria)

  • A substernal thyroid gland

  • Cervical bony exostosis

  • A thoracic tumor

For evaluation of potential esophageal obstruction, see Dysphagia.

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