Document Detail


Outcomes of acute esophageal food impaction: success of the push technique.
MedLine Citation:
PMID:  11174288     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Acute esophageal food impaction (AEFI) is the most common form of esophageal impaction in adults. The current recommendation for management is extraction by using an overtube to protect the airway, which facilitates multiple passages of the endoscope and protects the esophageal mucosa. Typically, AEFI in our patients is treated with the push technique, a method found to be highly successful and without complications. METHODS: All patients with a diagnosis of AEFI from 1993 to 1998 were identified by computer search of ICD-9 diagnosis code 935.1 (foreign body of the esophagus). Patients were excluded if they were less than 18 years of age, had an acute esophageal foreign body other than food, or if the medical record was incomplete. RESULTS: The analysis included 189 patients: 114 men and 75 women. Of these, 77 (41%) had a Schatzki's ring, 61 (32%) had an esophageal stricture, and 4 (2%) had esophageal cancer. In 47 patients (25%) no obvious structural cause for AEFI was noted at endoscopy. In addition, 67 patients had breaks in the esophageal mucosa. The push technique resolved the food impaction in 184 of 189 (97%) of the patients. In no subgroup was there an instance of perforation, aspiration, or bleeding. Forty-five patients underwent dilation at the time of food disimpaction without complication. CONCLUSIONS: The push technique is both safe and effective in the treatment of AEFI. Dilation at the initial presentation of a patient with AEFI likewise appears to be safe. The push technique is recommended as the initial therapy of choice for AEFI. Dilation at the time of esophageal food disimpaction can be considered if there are no obvious contraindications.
Authors:
J J Vicari; J F Johanson; J T Frakes
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  53     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-02-22     Completed Date:  2001-06-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  178-81     Citation Subset:  IM    
Affiliation:
Rockford Gastroenterology Associates, Ltd., Rockford, Illinois 61107, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Adult
Aged
Aged, 80 and over
Esophageal Diseases / etiology*,  therapy*
Female
Food*
Humans
Male
Middle Aged
Treatment Outcome

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


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