The evolution of treatment and complications of esophageal food impaction.
Adult
Aged
Deglutition Disorders
/ epidemiology
Endoscopy, Digestive System
/ adverse effects
Esophagus
/ diagnostic imaging
Female
Food
/ adverse effects
Foreign Bodies
/ epidemiology
Gastrointestinal Agents
/ administration & dosage
Humans
Incidence
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Endoscopic therapy
eosinophilic esophagitis
esophageal complications
esophageal food impaction
noninvasive therapy
Journal
United European gastroenterology journal
ISSN: 2050-6406
Titre abrégé: United European Gastroenterol J
Pays: England
ID NLM: 101606807
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
06
11
2018
accepted:
29
01
2019
entrez:
9
5
2019
pubmed:
9
5
2019
medline:
9
5
2019
Statut:
ppublish
Résumé
Esophageal food impaction is relatively common and increasing over time. Treatment ranges from medications to invasive endoscopic therapies. The endoscopic push technique has been advised against in favor of endoscopic retrieval for safety concerns. We sought to assess use patterns and safety of treatments for food impaction in a population-based retrospective review. A database of recorded esophageal food impactions in Olmsted County, MN, USA, from 1975-2011 was reviewed for patient demographics, treatment, and complications. A total of 645 impactions occurred, with increasing incidence over time, peaking at 23.2 per year (2000-2004). Medications (almost exclusively glucagon) were successful in relieving impactions 34.5% of the time when trialed. Urgent endoscopy was common (74.0%), as was the need for endoscopic therapy (67.1%). Endoscopic therapy increased over time, with the endoscopic push technique becoming most common. Esophageal complications (deep mucosal injury or perforation) increased over time but remained rare (peak 11%). There was no difference in complications between push and retrieval techniques. The endoscopic push technique is safe in comparison to endoscopic retrieval in esophageal food impactions. While complications surrounding impaction have increased, they remain rare. Medication trials are reasonable, as long as they do not delay endoscopy, and may prevent the need for emergent endoscopy in one-third of cases.
Sections du résumé
Background
Esophageal food impaction is relatively common and increasing over time. Treatment ranges from medications to invasive endoscopic therapies. The endoscopic push technique has been advised against in favor of endoscopic retrieval for safety concerns. We sought to assess use patterns and safety of treatments for food impaction in a population-based retrospective review.
Methods
A database of recorded esophageal food impactions in Olmsted County, MN, USA, from 1975-2011 was reviewed for patient demographics, treatment, and complications.
Results
A total of 645 impactions occurred, with increasing incidence over time, peaking at 23.2 per year (2000-2004). Medications (almost exclusively glucagon) were successful in relieving impactions 34.5% of the time when trialed. Urgent endoscopy was common (74.0%), as was the need for endoscopic therapy (67.1%). Endoscopic therapy increased over time, with the endoscopic push technique becoming most common. Esophageal complications (deep mucosal injury or perforation) increased over time but remained rare (peak 11%). There was no difference in complications between push and retrieval techniques.
Conclusions
The endoscopic push technique is safe in comparison to endoscopic retrieval in esophageal food impactions. While complications surrounding impaction have increased, they remain rare. Medication trials are reasonable, as long as they do not delay endoscopy, and may prevent the need for emergent endoscopy in one-third of cases.
Identifiants
pubmed: 31065372
doi: 10.1177/2050640619836052
pii: 10.1177_2050640619836052
pmc: PMC6488802
doi:
Substances chimiques
Gastrointestinal Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Pagination
548-556Subventions
Organisme : NIA NIH HHS
ID : R01 AG034676
Pays : United States
Références
Gastroenterol Res Pract. 2016;2016:9303858
pubmed: 27547221
Gastrointest Endosc. 2001 Feb;53(2):193-8
pubmed: 11174291
Gastrointest Endosc. 2011 Jun;73(6):1085-91
pubmed: 21628009
Aliment Pharmacol Ther. 2008 Nov 1;28(9):1140-6
pubmed: 18624788
Emerg Med Int. 2013;2013:924015
pubmed: 23738071
J Gastroenterol Hepatol. 2013 Jun;28(6):963-6
pubmed: 23425056
BMC Gastroenterol. 2016 Aug 18;16(1):95
pubmed: 27538991
J Clin Gastroenterol. 2006 Oct;40(9):784-9
pubmed: 17016132
World J Emerg Surg. 2018 Sep 12;13:42
pubmed: 30214470
Dis Esophagus. 2019 Apr 1;32(4):
pubmed: 30295715
Dig Liver Dis. 2013 Jul;45(7):529-42
pubmed: 23266207
Dig Dis Sci. 2018 Jun;63(6):1428-1437
pubmed: 29460159
J Clin Gastroenterol. 2019 Mar;53(3):179-183
pubmed: 29517706
Gastrointest Endosc. 2001 Feb;53(2):178-81
pubmed: 11174288
Gastrointest Endosc. 2011 Nov;74(5):985-91
pubmed: 21889135
Gastrointest Endosc. 1995 Jan;41(1):33-8
pubmed: 7698622
Endoscopy. 2016 May;48(5):489-96
pubmed: 26862844
Aliment Pharmacol Ther. 2015 Jul;42(1):91-8
pubmed: 25963885
Dig Dis Sci. 2016 Mar;61(3):841-5
pubmed: 26500116
Am J Gastroenterol. 2007 Dec;102(12):2627-32
pubmed: 17764492