Original ArticlesOutcomes of acute esophageal food impaction: Success of the push technique☆
Section snippets
Patients and methods
All patients with a diagnosis of AEFI made from 1993 to 1998 were identified by computer search of our billing database (Physicians Computer Network, Morris Plains, N.J.) for ICD-9 diagnosis code 935.1 (foreign body of the esophagus). Five-year retrospective data are available with this software package. Patients were excluded if they were less than 18 years of age, they had acute esophageal obstruction by a foreign body rather than food impaction, or if their chart was incomplete (missing or
Results
The analysis included 189 patients with a mean age of 60 years (range 18-97). There were 114 men (mean age 55.5 years) and 75 women (mean age 66.4 years). There were 86 patients (46%) over the age of 65 years and 28 patients (15%) over the age of 80 years.
Seventy-seven patients (41%) had a Schatzki's ring, 61 (32%) had an esophageal stricture, and 4 (2%) had esophageal cancer. In addition to these findings, 67 patients had breaks in the esophageal mucosa. In 47 patients (25%), no obvious
Discussion
AEFI is the most common cause of acute esophageal obstruction in adults.2 The push technique has been reported to be safe and effective in the management of patients with AEFI.2, 7, 8, 9, 10 The push technique is advocated in certain clinical situations, such as in patients without a history of dysphagia, in those with a history of dysphagia of short duration, or in those in whom the food bolus has fragmented and extraction is difficult.2, 7, 10 In cases in which there is a solid food bolus, an
Acknowledgements
We thank Arnold M. Rosen, MD, for his helpful comments and suggestions in reviewing this manuscript.
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2020, Gastrointestinal EndoscopyCitation Excerpt :The rates of structural esophageal pathologies in our study were comparable with previous articles, with reported rates of peptic strictures and Schatzki’s rings between 12% and 69% and 7% and 43%, respectively.6,13,15-18 Esophageal cancers are found in nearly 2% of foreign body ingestion cases, which is similar to our findings.15,18 Esophagitis was present in 40% of cases after removal of the impaction.
Esophageal perforation in eosinophilic esophagitis: A systematic review on clinical presentation, management and outcomes
2020, Digestive and Liver DiseaseCitation Excerpt :Thirdly, we identified using the endoscope to push food into the stomach as a potentially risky maneuver for esophageal perforation in EoE [31,60,66,67,70]. Despite a recent retrospective series showing the push technique to be as safe and effective as the pull technique in managing esophageal food bolus impaction in adults [81–84] and children [85], only a minority of patients had EoE. Until we have prospective studies to assess the safety of pushing the food bolus into the stomach in patients with known or suspected EoE, caution should be recommended with this technique.
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Reprint requests: Joseph J. Vicari, MD, Rockford Gastroenterology Associates, 401 Roxbury Road, Rockford, IL 61107.