Differential Diagnosis for Foreign Body Sensation after Eating Chicken

The patient's symptoms of a foreign body sensation in the back of the throat after eating chicken, with a negative CT scan, can be approached by considering the following categories:

• Single Most Likely Diagnosis
  • Esophageal spasm or dysphagia: This is a common condition where the esophagus experiences abnormal muscle contractions, which can give a sensation of something being stuck. The fact that the CT scan is negative makes a physical obstruction less likely, pointing towards a functional issue like esophageal spasm.
• Other Likely Diagnoses
  • Gastroesophageal reflux disease (GERD): Symptoms of GERD can include a sensation of food being stuck in the throat, especially after eating certain foods. The negative CT scan does not rule out GERD, as it is a functional disorder.
  • Esophagitis: Inflammation of the esophagus, possibly due to acid reflux or an infection, could cause discomfort and a sensation of a foreign body.
  • Pharyngitis: Inflammation of the pharynx could lead to a sensation of something being stuck, especially if the inflammation is caused by eating certain foods.
• Do Not Miss Diagnoses
  • Esophageal cancer: Although less likely, especially with a negative CT scan, esophageal cancer can cause dysphagia and a sensation of food being stuck. It's crucial to not miss this diagnosis due to its severe implications.
  • Foreign body obstruction: Despite the CT being negative, it's essential to consider the possibility of a small foreign body or an object not visible on the CT scan, especially if the symptoms persist.
• Rare Diagnoses
  • Eosinophilic esophagitis: A chronic immune system disease in which a type of white blood cell, the eosinophil, builds up in the esophagus in response to an allergen or irritant, leading to inflammation and potentially a sensation of food being stuck.
  • Zenker's diverticulum: A condition where a pouch forms in the pharynx, which can trap food and cause symptoms similar to those described, although it's less common and might not be directly related to eating chicken specifically.

Each of these diagnoses should be considered in the context of the patient's full medical history, physical examination, and potentially further diagnostic testing to determine the most appropriate diagnosis and treatment plan.