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Causes of bolus impaction in the esophagus

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Abstract

Background

Bolus impaction in the esophagus is a common indication for emergency endoscopy. The aim of this study was to determine the most common causes of esophageal bolus impaction.

Methods

In this retrospective study, data of 54 patients (41 male, 13 female) with bolus impaction in the esophagus were analyzed. Type and localization of the bolus and the endoscopic extraction tool used were evaluated. In 48 of 54 patients (89%), biopsy samples were taken of the esophagus for histological examination.

Results

Mean age of the patients was 53 ± 20 years. Fourteen of 54 patients (26%) had experienced bolus impaction previously. Meat bolus (n = 35, 65%) was the most common cause of esophageal obstruction. In most cases, boluses were found in either the distal (n = 31) or the proximal (n = 18) esophagus. In 22 patients (41%), the bolus was pushed into the stomach by the endoscope. In most other cases the bolus, including foreign bodies, could be removed with the 5-arm polyp grasper or alligator forceps. Main causes of bolus impaction were eosinophilic esophagitis (n = 10) or reflux disease with or without peptic stenosis (n = 10), respectively.

Conclusion

Bolus impaction is frequently correlated with eosinophilic esophagitis and reflux esophagitis; therefore, diagnostic workup should include esophageal biopsy sampling.

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Disclosures

G. I. Kirchner, I. Zuber-Jerger, E. Endlicher, C. Gelbmann, C. Ott, P. Ruemmele, J. Schölmerich, and F. Klebl have no conflicts of interest or financial ties to disclosure.

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Authors and Affiliations

  1. Department of Internal Medicine I, University Hospital of Regensburg, 93042, Regensburg, Germany

    Gabriele I. Kirchner, Ina Zuber-Jerger, Esther Endlicher, Cornelia Gelbmann, Claudia Ott, Jürgen Schölmerich & Frank Klebl

  2. Institute of Pathology, University Hospital of Regensburg, 93042, Regensburg, Germany

    Petra Ruemmele

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  1. Gabriele I. Kirchner
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  2. Ina Zuber-Jerger
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  3. Esther Endlicher
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  4. Cornelia Gelbmann
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  5. Claudia Ott
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  6. Petra Ruemmele
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  7. Jürgen Schölmerich
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Correspondence to Gabriele I. Kirchner.

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Kirchner, G.I., Zuber-Jerger, I., Endlicher, E. et al. Causes of bolus impaction in the esophagus. Surg Endosc 25, 3170–3174 (2011). https://doi.org/10.1007/s00464-011-1681-6

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  • DOI: https://doi.org/10.1007/s00464-011-1681-6

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