Abstract
Background
Esophageal food bolus impaction is an uncommon entity in the pediatric population that presents with the acute onset of dysphagia, pain, and vomiting. The causes of esophageal food bolus impaction are thought to be different in the pediatric population as compared to adults.
Aim
The purpose of this study was to determine the frequency of the different causes of food impaction in patients who undergo an esophagram or upper GI examination.
Methods
The radiology report database was searched to identify all patients with an esophageal food bolus impaction diagnosed on upper GI or esophagram between 1993 and 2009. Two pediatric radiologists then evaluated each esophagram to determine the location of the filling defect within the esophagus. Finally, the electronic medical record was queried to identify demographic information and abnormalities associated with the food impaction.
Results
After querying the radiology database, 43 patients were identified with an impacted food bolus on esophagram or upper GI. There were three abnormalities associated with food impaction: eosinophilic esophagitis (23/43; 53%), prior esophageal atresia repair (11/43; 26%), and prior Nissen fundoplication (5/43; 12%). There were eight patients in whom no underlying abnormality was identified.
Conclusions
Eosinophilic esophagitis is the major abnormality associated with food bolus impaction in pediatric patients followed by narrowing at the site of prior esophageal or esophageal-related surgery.
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References
Lao J, Bostwick HE, Berezin S, Halata MS, Newman LJ, Medow MS. Esophageal food impaction in children. Pediatr Emerg Care. 2003;19:402–407.
Longstreth GF, Longstreth KJ, Yao JF. Esophageal food impaction: epidemiology and therapy. A retrospective, observational study. Gastrointest Endosc. 2001;53:193–198.
Underberg-Davis S, Levine MS. Giant thoracic osteophyte causing esophageal food impaction. AJR Am J Roentgenol. 1991;157:319–320.
Byrne KR, Panagiotakis PH, Hilden K, Thomas KL, Peterson KA, Fang JC. Retrospective analysis of esophageal food impaction: differences in etiology by age and gender. Dig Dis Sci. 2007;52:717–721.
Blanchard C, Rothenberg ME. Basic pathogenesis of eosinophilic esophagitis. Gastrointest Endosc Clin N Am. 2008;18:133–143.
Furuta GT, Liacouras CA, Collins MH, Gupta SK, et al. Eosinophilic esophagitis in children and adults: a systematic review and consensus recommendations for diagnosis and treatment. Gastroenterology. 2007;133:1342–1363.
Assa’ad AH, Putnam PE, Collins MH, Akers RM, et al. Pediatric patients with eosinophilic esophagitis: an 8-year follow-up. J Allergy Clin Immunol. 2007;119:731–738.
Blanchard C, Wang N, Rothenberg ME. Eosinophilic esophagitis: pathogenesis, genetics, and therapy. J Allergy Clin Immunol. 2006;118:1054–1059.
Luis AL, Riñon C, Encinas JL, Prieto G, et al. Non stenotic food impaction due to eosinophilic esophagitis: a potential surgical emergency. Eur J Pediatr Surg. 2006;16:399–402.
Kerlin P, Jones D, Remedios M, Campbell C. Prevalence of eosinophilic esophagitis in adults with food bolus obstruction of the esophagus. J Clin Gastroenterol. 2007;41:356–361.
Desai TK, Stecevic V, Chang CH, Goldstein NS, Badizadegan K, Furuta GT. Association of eosinophilic inflammation with esophageal food impaction in adults. Gastrointest Endosc. 2005;61:795–801.
Straumann A, Bussmann C, Zuber M, Vannini S, Simon HU, Schoepfer A. Eosinophilic esophagitis: analysis of food impaction and perforation in 251 adolescent and adult patients. Clin Gastroenterol Hepatol. 2008;6:598–600.
Focht DR, Kaul A. Food impaction and eosinophilic esophagitis. J Pediatr. 2005;147:540.
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Diniz, L.O., Towbin, A.J. Causes of Esophageal Food Bolus Impaction in the Pediatric Population. Dig Dis Sci 57, 690–693 (2012). https://doi.org/10.1007/s10620-011-1911-8
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DOI: https://doi.org/10.1007/s10620-011-1911-8