Document Detail


Esophageal food bolus obstruction: evaluation of extraction and modified push techniques in 75 cases.
MedLine Citation:
PMID:  10494678     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND STUDY AIMS: Endoscopic extraction is the standard method of treating esophageal food bolus obstructions. The efficacy, efficiency, and safety of various techniques used over a 12-year period were evaluated. PATIENTS AND METHODS: Seventy-five procedures with soft food bolus obstruction were analyzed. If endoscopic extraction failed, or it was determined that alternative techniques would be effective, food was pushed into the stomach by: a) the endoscope tip, with or without a guide wire; or b) the wire-guided Savary dilators. The duration of the procedures included therapeutic Savary dilation (in 61 of 75 cases). RESULTS: Food bolus obstruction was associated with peptic strictures (69%), Schatzki's rings (19%), and tight fundoplications (3 %). No narrowing was seen in 9%. Extraction, scope push and Savary push methods were successful in seven of 16, 48 of 48, and 20 of 20 attempts, respectively. The mean duration, including stricture dilation (+/- 1 standard deviation), for the extraction, scope push and Savary push procedures were 32 (+/- 17), 18 (+/- 14) and 27 (+/- 15) mm, respectively. No cases of perforation, hemorrhage, oxygen desaturation, aspiration, or pneumonia occurred. CONCLUSIONS: Management of esophageal food bolus obstructions by modified push methods and esophageal dilation in the same session appears to be effective, efficient and safe. The methods employed should be individualized for each patient. Push methods require experience and judgment.
Authors:
L B Weinstock; B A Shatz; S E Thyssen
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Endoscopy     Volume:  31     ISSN:  0013-726X     ISO Abbreviation:  Endoscopy     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-10-19     Completed Date:  1999-10-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0215166     Medline TA:  Endoscopy     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  421-5     Citation Subset:  IM    
Affiliation:
Dept. of Medicine, Barnes-Jewish Hospital, Washington University School of Medicine, St. Louis, Missouri, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Dilatation
Endoscopy, Digestive System / methods*
Esophageal Stenosis / etiology,  therapy*
Female
Food*
Foreign Bodies / etiology,  therapy*
Humans
Male
Middle Aged
Pliability
Prospective Studies
Recurrence
Retrospective Studies
Treatment Outcome

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


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