Document Detail


Assessment of the predictors of response to glucagon in the setting of acute esophageal food bolus impaction.
MedLine Citation:
PMID:  14745641     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Esophageal food impactions are frequently seen in endoscopic practice. Glucagon is known to relax the lower esophageal sphincter and has been used with variable success to treat food impactions. We retrieved clinical information of all patients with acute food impactions who attended the emergency room from 1975 to 2000 from the Mayo diagnostic database. Data were abstracted on age, sex, body mass index, relevant prior medical history, food type ingested (meat, bread, vegetable, or other), duration of symptoms at presentation, dosage (in mg) of glucagon, outcome including success of glucagon or spontaneous passage, and endoscopic findings. A total of 222 cases of food impaction were identified, of whom 106 patients (48%) received glucagon, average 1 mg. In glucagon responders, meat was less likely to be the offending food type, accounting for 70% (glucagon responders) vs. 90% (in nonresponders) ( p = 0.03), while responders were less likely to have esophageal rings/strictures detected on subsequent EGD compared with nonresponders, 0% (glucagon responders) vs. 31% (nonresponders) ( p = 0.05). In the patients that did not receive glucagon, spontaneous resolvers had a shorter duration of symptoms at presentation, 3.3 h vs. 12.4 h ( p = 0.07) and were less likely to have an organic esophageal obstruction detected on EGD, 0% vs. 21%. There were no significant differences between the resolvers and nonresolvers in terms of age, gender, BMI, and prior medical history. Conservative management of acute food bolus obstruction, either with or without glucagon, is most successful in the absence of a fixed esophageal obstruction. An impacted meat bolus is more likely to require intervention for removal than other food types. These clinical predictors should be considered before administration of glucagon.
Authors:
Thomas C Sodeman; Gavin C Harewood; Todd H Baron
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Dysphagia     Volume:  19     ISSN:  0179-051X     ISO Abbreviation:  Dysphagia     Publication Date:  2004  
Date Detail:
Created Date:  2004-01-27     Completed Date:  2004-04-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8610856     Medline TA:  Dysphagia     Country:  United States    
Other Details:
Languages:  eng     Pagination:  18-21     Citation Subset:  D; IM    
Affiliation:
Department of Medicine, Division of Gastroenterology, Mayo Medical Center, Rochester, Minnesota, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Case-Control Studies
Esophagus*
Female
Food
Foreign Bodies / drug therapy*
Glucagon / administration & dosage*
Humans
Injections, Intravenous
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
9007-92-5/Glucagon
Comments/Corrections
Comment In:
Dysphagia. 2004 Winter;19(1):15-7   [PMID:  14986656 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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