The radiological management of oesophageal food bolus obstruction using a gas-forming agent and barium

Spinou, Ekaterini; Kubba, Haytham; Guse, Julian; Johnston, Andrew D.

doi:10.1016/s0385-8146(02)00054-8

Cited by 10 publications

(12 citation statements)

References 11 publications

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“…On review of the literature, four retrospective cohort studies [6][7][8][9] and one case report 10 were identified. These studies reported disimpaction rates of 100%, 6 100% 7 100% 10 80% 8 and 65%, 9 with gas forming agents alone.…”

Section: Gas Forming Agentsmentioning

confidence: 99%

“…9 The total literature on the use of effervescents in OSFBO has low patient numbers and the gas forming agent varies in each study. [6][7][8][9] Nevertheless, the results of the studies were positive, with 79% of cases experiencing disimpaction with a gas forming agent alone or with barium for imaging (as described in the case report 10 ). This combination therapy has not been replicated in a larger study.…”

Section: Gas Forming Agentsmentioning

confidence: 99%

“…> (oesophagus OR esophagus) AND (cola OR coke OR coca-cola OR effervescent OR carbonated OR gas forming) -this yielded four retrospective cohort studies [6][7][8][9] and one case report; 10 > (oesophagus OR esophagus) AND glucagon -this yielded one randomised controlled trial 11 and two further studies; 12,13 Buscopan (+/-fluids only) (7) Spontaneous disimpactation (n=11) …”

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confidence: 99%

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The management of oesophageal soft food bolus obstruction: a systematic review

Leopard

Fishpool

Winter

2011

annals

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A food bolus obstruction of the oesophagus represents a potentially serious medical problem. It is generally agreed that sharp objects becoming lodged in the oesophagus or objects with a corrosive capacity (eg batteries) should be removed urgently.1 However, the management of oesophageal soft food bolus obstruction (OSFBO) is less clear. The aim of treatment is to prevent the occurrence of potentially serious complications of bolus obstruction, including perforation and mediastinitis. These complications may occur due to mucosal ischaemia resulting from prolonged impaction or iatrogenically during surgical removal.2 In many cases, therefore, the aim of treatment is initially to manage the patient medically to encourage resolution of the obstruction.The management of patients with OSFBO frequently involves a variety of specialties, either individually or in combination. These include the emergency care, general surgery and ENT teams. Currently, however, there is no recognised guidance regarding which medications are efficacious in the resolution of OSFBO. Furthermore, the timing of administration of any medical or surgical treatment is often based entirely on clinical judgement. The aim of this study was to perform a literature review regarding the management of OSFBO. MethodsA review of the literature was performed to evaluate the published evidence regarding pharmacological and surgical treatment of OSFBO. The Singleton Hospital library information department undertook searches of the Cochrane Library, the National Center for Biotechnology Information and the US National Library of Medicine resources. The following search strategies were used: > (oesophagus OR esophagus) AND buscopan -this yielded one case study 3 and two retrospective cohort studies;4,5 > (oesophagus OR esophagus) AND (cola OR coke OR coca-cola OR effervescent OR carbonated OR gas forming) -this yielded four retrospective cohort studies 6-9 and one case report; 10 > (oesophagus OR esophagus) AND glucagon -this yielded one randomised controlled trial 11 and two further studies; RESULTSThis systematic review of the management of OSFBO shows no evidence that any medical intervention is more effective than a 'watch and wait' policy in enabling spontaneous disimpaction. Furthermore, the use of hyoscine butylbromide for OSFBO probably stems from a misquoted textbook. Surgical removal of an OSFBO is effective but not without potential risk. There is some evidence to support surgical intervention within 24 hours to prevent complications deriving from the initial obstruction. CONCLUSIONS There is a need for large double-blind, randomised, placebo controlled trials of drugs used in the medical management of OSFBO. Until the results from such trials are available, the treatment of OSFBO will remain based on inconsistent clinical judgement.

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Section: Gas Forming Agentsmentioning

confidence: 99%

Section: Gas Forming Agentsmentioning

confidence: 99%

mentioning

confidence: 99%

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The management of oesophageal soft food bolus obstruction: a systematic review

Leopard

Fishpool

Winter

2011

annals

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“…The other non‐surgical options for meat bolus obstruction reported in literature include the use of diazepam, 3 meperidine (pethidine), 3 atropine, 3 glucagon, 12 proteolytic enzymes such as papain, 13 barium swallow with gas‐forming agents, 14 Coca‐Cola, 15 pineapple juice, 16 nifedipine, 17 and trypsin 18 …”

Section: Discussionmentioning

confidence: 99%

Is buscopan effective in meat bolus obstruction?

Thomas

Webb

Duvvi

et al. 2005

Clinical Otolaryngology

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“…Case reports describe contrast media aiding the passage of meat boluses into the stomach. 6 The technique of pushing the bolus is the same as that used in the majority of cases cleared by flexible endoscopy. 2, 3 Although successful in this specific case the complication rate of the technique described is unknown.…”

Section: Discussionmentioning

confidence: 99%

Lower oesophageal meat bolus clearance using a radiologically guided balloon catheter: case in a 94–year–old patient

et al. 2004

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Lower oesophageal foreign body meat bolus obstruction is potentially life-threatening. We report a case in a 94-year-old woman in which conservative measures and flexible oesophagoscopy were unsuccessful. Rigid oesophagoscopy was considered technically difficult and so clearance by interventional radiology was attempted. Through the mouth a radiologically guided balloon catheter was introduced. It was passed beyond the bolus to dilate the site of obstruction, before being withdrawn and inflated above the bolus, pushing it into the stomach. Although successful in this case, the technique is previously unreported and so its complication rate is unknown. It is therefore presented only to be considered when other treatments are neither effective nor possible.

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The radiological management of oesophageal food bolus obstruction using a gas-forming agent and barium

Cited by 10 publications

References 11 publications

The management of oesophageal soft food bolus obstruction: a systematic review

The management of oesophageal soft food bolus obstruction: a systematic review

Is buscopan effective in meat bolus obstruction?

Lower oesophageal meat bolus clearance using a radiologically guided balloon catheter: case in a 94–year–old patient

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