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Acute food bolus impaction: aetiology and management

Published online by Cambridge University Press:  29 June 2007

Peter D. Lacy
Affiliation:
Department of Otolaryngology, St. James's Hospital, Dublin.
Martin J. Donnelly
Affiliation:
Department of Otolaryngology, St. James's Hospital, Dublin.
Joseph P. McGrath
Affiliation:
Department of Head & Neck Surgery and Surgery, St. James's Hospital, Dublin.
Patrick J. Byrne
Affiliation:
Department of Head & Neck Surgery and Surgery, St. James's Hospital, Dublin.
Thomas P. J. Hennessy
Affiliation:
Department of Head & Neck Surgery and Surgery, St. James's Hospital, Dublin.
Conrad V. I. Timon*
Affiliation:
Department of Otolaryngology, St. James's Hospital, Dublin.
*
Address for correspondence: Professor C. V. I. Timon, Department of Otolaryngology, Head & Neck Surgery, St. James's Hospital, James's Street, Dublin 8, Ireland.

Abstract

A prospective study into the aetiology of acute food bolus obstruction (AFBO) was carried out on 17 consecutive patients who presented with this complaint. There were nine males and eight females. Twelve patients (71 per cent) had symptoms of oesophageal disease and 10 patients (59 per cent) had prior food bolus obstruction. Investigations included endoscopy, barium swallow, oesophageal pH and manometry studies. Evidence of oesophageal pathology was found in 12/14 (86 per cent) of patients investigated. No patients had malignancy and the most common abnormality, gastroesophageal reflux (GOR) was found in eight out of 14 (57 per cent) of cases. Oesophageal dysmotility was seen in five out of 12 (42 per cent) patients who had manometric studies.

With such a high incidence of recurrence of AFBO, we suggest that patients with this condition be investigated to exclude malignancy and to identify benign oesophageal pathology using techniques such as oesophageal pH and manometry. Appropriate treatment of oesophageal disease may help prevent recurrence of this distressing condition.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1997

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References

Bell, A. F., Eibling, D. E. (1988) Nifedipine in the treatment of distal oesophageal food impaction. Archives of Otolaryngology - Head and Neck Surgery 114: 682683.Google Scholar
De Meester, T. R., Wang, C., Wernly, J. A., Pellegrini, C. A., Little, A. G., Klementschitsch, P., Bermudez, G., Johnson, L. F., Skinner, D. B. (1980) Technique, indications, and clinical use of 24 hour oesophageal pH monitoring. Journal of Thoracic and Cardiovascular Surgery 79: 656670.Google Scholar
Jones, N. S., Lannigan, F. J., Salama, N. Y. (1991) Foreign bodies in the throat: a prospective study of 388 cases. Journal of Laryngology and Otology 105: 104108.Google Scholar
Jones, P. A. (1978) Oesophageal bolus extraction by a balloon catheter. British Medical Journal 1: 819820.Google Scholar
Karanjia, N. D., Rees, M. (1993) The use of Coca-Cola in the management of bolus obstruction in benign oesophageal stricture. Annals of the Royal College of Surgeons in Edinburgh 75: 9495.Google ScholarPubMed
Kaszar-Seibert, D. J., Korn, W. T., Bindman, D. J., Shortsleeve, M. J. (1990) Treatment of acute oesophageal food impaction with a combination of Glucagon, effervescent agent and water. American Journal of Radiology 154: 533534.Google Scholar
Norton, R. A., King, G. D. (1963) ‘Steakhouse Syndrome’: the symptomatic lower oesophageal ring. Lahey Clinic Foundation Bulletin 13: 5559.Google Scholar
Palmer, E. D. (1976) Backyard barbecue syndrome. Journal of the American Medical Association 235: 26372638.Google Scholar
Phillipps, J. J., Patel, P. (1988) Swallowed foreign bodies. Journal of Laryngology and Otology 102: 235241.Google Scholar
Saeed, Z. A., Michaletz, P. A., Feiner, S. D., Woods, K. L., Graham, D. Y. (1990) A new endoscopic method for managing food impaction in the oesophagus. Endoscopy 22: 226228.CrossRefGoogle Scholar
Stadler, J., Holscher, A. H., Feussner, H., Dittler, J., Siewert, J. R. (1989) The ‘Steakhouse syndrome’: Primary and definitive diagnosis and treatment. Endoscopy 3: 195198.Google Scholar
Taylor, R. B. (1987) Oesophageal foreign bodies. Emergency Clinics of North America 5: 301311.CrossRefGoogle Scholar
Tibbling, L., Stenquist, M. (1991) Foreign bodies in the oesophagus. A study of causative factors. Dysphagia 6: 224227.Google Scholar
Triadafilopoulos, G. (1989) On obstructive dysphagia in reflux esophagitis. American Journal of Gastroenterology 84: 614618.Google Scholar