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Food bolus and oesophageal foreign body: a summary of the evidence and proposed management process

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Abstract

Purpose

Food bolus and oesophageal foreign bodies are a common presentation that may be managed by otolaryngologists, gastroenterologists, acute medicine physicians and accident and emergency. The condition is highly variable with presentations ranging from well patients whose obstruction spontaneously passes to peri-arrest with severe aspiration or impending airway compromise. Management of this condition is heterogeneous and often depends on the specialty the patient is originally admitted under. There exist European and American guidelines from the perspective of gastroenterology, but there are no UK-based guidelines and limited consideration of the role of the otolaryngologists and rigid oesophagoscopy.

Methods

An extensive literature search was carried out to generate conclusions on key management questions for food bolus and oesophageal foreign bodies. This was then summarised into both a written summary of the evidence and a graphical decision tree.

Results

This paper is a review article and presents conclusions regarding management options for food bolus and oesophageal foreign bodies.

Conclusion

This article considers the current evidence surrounding investigation and management of oesophageal food bolus and foreign body. It draws conclusions regarding presentation, investigation and subsequent operative treatment. As part of this process, we propose a graphical decision tree to assist in management decisions.

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Fig. 1

Adapted from Birk et al. [9]

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Availability of data and material

No new data was generated as part of this article, it represents primarily a review and summary of existing material.

Code availability

No computer code, calculations or data processing solutions were created or used for the creation of this document.

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Funding

No funding was sought or provided for the publication of this document. All work on this document was carried out during the authors own time.

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Authors and Affiliations

  1. Department of Otolaryngology, Royal Derby Hospital, Derby, UK

    Thomas J. Stubington

  2. Department of Otolaryngology, Queens Medical Centre, Nottingham, UK

    Tawakir Kamani

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Contributions

S carried out the literature review, read and summarised the relevant literature and wrote the final article. K provided assistance in focusing the topic, additional clinical correlation and direction and editorial assistance.

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Correspondence to Thomas J. Stubington.

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Stubington, T.J., Kamani, T. Food bolus and oesophageal foreign body: a summary of the evidence and proposed management process. Eur Arch Otorhinolaryngol 278, 3613–3623 (2021). https://doi.org/10.1007/s00405-020-06569-5

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  • DOI: https://doi.org/10.1007/s00405-020-06569-5

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