Etiology and management of esophageal food impaction: a population based study

Grétarsdóttir, Helga María; Jonasson, Jón G.; Bjõrnsson, Einar

doi:10.3109/00365521.2014.983159

Cited by 47 publications

(45 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The most frequently identified oesophageal pathology in the present study was EO ( n = 23, 19.8%). This frequency is comparable to other studies, although there is variability among the literature as to whether benign stricture or EO is the dominant pathology in the cause of FBO …”

Section: Discussionsupporting

confidence: 87%

“…This frequency is comparable to other studies, although there is variability among the literature as to whether benign stricture or EO is the dominant pathology in the cause of FBO. [2][3][4]18,19 Our data not only shows no benefit to the use of medical therapy in the management of FBO, but also that in our institution, which has good access to emergent endoscopy, medical therapy delays endoscopy. We therefore endorse the recommendation that the use of medical therapy in FBO should not delay endoscopy.…”

Section: Discussionmentioning

confidence: 56%

“…Oesophageal food bolus obstruction (FBO) is the most common gastrointestinal (GI) emergency after upper and lower GI bleeding with an estimated incidence of 13-25/100 000 per year, which may be increasing over time. [1][2][3] It is more common in men, increases in incidence with age and meat is the most common causative food type, accounting for between 68% and 85% of presentations. [1][2][3][4] In this sense, FBO differs from other solid foreign body ingestions, which are more common in children and those with psychiatric comorbidity or intoxication.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] It is more common in men, increases in incidence with age and meat is the most common causative food type, accounting for between 68% and 85% of presentations. [1][2][3][4] In this sense, FBO differs from other solid foreign body ingestions, which are more common in children and those with psychiatric comorbidity or intoxication. 5 Underlying oesophageal pathology is found in between 67% and 88% of cases, with benign peptic strictures and Schatzki rings being the most common.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 Furthermore, serious complications of therapeutic endoscopy for FBO such as perforation are rare, with rates of perforation <1%, while other complications, for example mucosal laceration or aspiration, may occur in up to 5% of cases. 1,2,7 Complication rates are higher when the interval between impaction and endoscopy exceeds 24 h, 8 and consequently early endoscopic therapy is recommended by international guidelines. 9,10 Despite the efficacy of endoscopy as the primary intervention for FBO, conservative approaches to the management of FBO are common.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Early referral for endoscopy is the most appropriate management strategy in cases of food bolus obstruction

Fulforth

Chen

Falvey

2019

Emerg Medicine Australasia

View full text Add to dashboard Cite

Objective To investigate the characteristics of patients presenting with oesophageal food bolus obstruction (FBO) who achieve early resolution of symptoms, and to assess the impact of medical therapies on the overall time course of FBO. Methods A retrospective observational study was performed in a university teaching hospital with regional acute endoscopy services. Patients presenting with symptoms of FBO were identified through clinical coding and demographic, clinical and endoscopic data extracted from the electronic medical record. The primary outcome was the time to resolution defined as the earliest of symptom resolution, endoscopic or surgical intervention or discharge. Results A total of 116 patients presented with symptoms of FBO. Twenty‐seven (23.3%) had early resolution of symptoms and were discharged from the ED without acute endoscopy, the remainder were admitted for further management. Patients discharged from the ED presented to hospital sooner after the onset of symptoms (137 vs 288 min, P < 0.05), but did not differ from those admitted in any other characteristic. Seventy‐one (61.2%) patients received medical therapy. There was no statistical difference in the time to resolution between those who received medical therapy and those who did not. Furthermore, the use of medical therapy was associated with a delay in referral for endoscopy (140 vs 100 min, P < 0.05). Conclusions Time from symptom onset to presentation is the only predictor of early resolution from FBO, while medical therapy is ineffective in relieving obstruction and may delay definitive therapy. We recommend the use of an institutional management plan to facilitate early access to endoscopy in cases of FBO.

show abstract

Section: Discussionsupporting

confidence: 87%