Causes of bolus impaction in the esophagus
Surgical Endoscopy, 04/26/2011
Kirchner GI et al. – Bolus impaction is frequently correlated with eosinophilic esophagitis and reflux esophagitis; therefore, diagnostic workup should include esophageal biopsy sampling.Methods
- 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.
- Mean age of the patients was 53 ± 20 years.
- 14 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).