Oesophageal Food Bolus Impaction (OFBI)

Background

• OFBI: 13 per 100,000 patients ^[1]
• Majority = 'mechanical impaction'
• Delayed Mx = risk (aspiration, oesophageal perforation) ^[2-6]
• <25% spontaneous resolution
• Success: 'medical' 40%, 'endoscopic' 95%

Management

• Medical Expulsion Therapy (MET) aims to ↑ oesophageal motility and ↓ oesophageal sphincter
• Endoscopy enables removal under direct vision

Approach

Links

• Boerhaave

References

1. Khayyat, 2013. Pharmacological Management of Oesophageal Food Bolus Impaction. Emergency Medicine International, Volume 2013.
2. Brit Long, 2019. Oesophageal Foreign Bodies and Obstruction in the Emergency Department Setting: An Evidence-Based Review. The Journal of Emergency Medicine, May , 56(5), pp. 499-511.
3. D Leopard, 2011. The management of oesophageal soft food bolus obstruction: a systematic review. Annals The Royal College of Surgeons of England, September.pp. 441-444.
4. Daniel A Schupack, 2019. The evolution of treatment and complications of oesophageal food impaction. United European Gastroenterol J, May, 7 (4), p. 548–556.
5. G F Longstreth, 2001. Esophageal food impaction: epidemiology and therapy. A retrospective, observational study. Gastrointestinal Endoscopy, February, 53(2), pp. 193-198.
6. Jason Haas, 2016. Glucagon Is a Safe and Inexpensive Initial Strategy in Esophageal Food Bolus Impaction. Digestive Diseases and Sciences, March, 61 (3), pp. 841-845.