TABLE 56.3 LIFE-THREATENING CAUSES OF DYSPHAGIA Foreign-body aspiration/ingestion Anaphylaxis Tracheoesophageal fistula Upper airway obstruction Traumatic esophageal perforation Epiglottitis Retropharyngeal abscess Botulism Tetanus Polio Diphtheria Central nervous system infection/abscess Stevens–Johnson syndrome Corrosive ingestion Laryngeal paralysis Life-threatening causes of dysphagia may involve airway compromise, serious local or systemic infection, and inflammatory disease ( Table 56.3 ) The newborn may have a congenital anatomic abnormality, such as tracheoesophageal fistula, with aspiration of swallowed fluid into the lungs, or may have traumatic injury to the upper airway and esophagus from iatrogenic instrumentation in the delivery room The older child may have a foreign body in the airway or esophagus, with the possibility of complete airway obstruction (see Chapter Airway ) Anaphylaxis or other allergic and infectious processes may present with dysphagia and can threaten airway integrity These include epiglottitis, retropharyngeal abscess, Stevens–Johnson syndrome, and central nervous system infections