Brief communicationEosinophilic Esophagitis: Analysis of Food Impaction and Perforation in 251 Adolescent and Adult Patients
Section snippets
Methods
The Swiss EE Study Group consecutively enrolls patients presenting with a confirmed (by using clinical, endoscopic, and histologic methods) diagnosis into a Swiss EE Database, SEED, which was nationally established in 1989. Inclusion criteria are (1) PPI-resistant esophageal-related symptoms, (2) EE-consistent endoscopic abnormalities, (3) infiltration of the esophageal mucosa with at least 24 eosinophils/high-power field (HPF), and (4) informed consent.
We performed a chart review and included
Results and Case Presentation
The SEED documents a total of 251 confirmed EE cases in adults and adolescents. During this 18-year period, 87 patients (34.7%) experienced 1 or more (range, 1–5) persistent food impactions requiring endoscopic bolus removal. A total of 134 emergency endoscopies were undertaken to remove impacted food. Of these, 124 (92.5%) were performed with flexible gastrointestinal (GI) endoscopy under sedation and 10 (7.5%) by rigid ENT endoscopy under general anesthesia. The selection of the procedure
Discussion and Conclusions
We report here on our 18-year experience with food impaction and esophageal perforation in 251 EE patients. In addition, we present 2 EE patients in whom the esophageal perforation was procedure-induced and 1 case in which rupture was associated with Boerhaave's syndrome. The management of persistent food impaction with the potentially fatal complication of an esophageal breach has several important clinical and legal consequences.
Food impaction is a common complication in EE patients.5 More
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