Department of Internal Medicine I, University Hospital of Regensburg, Regensburg, Germany.
Surg Endosc. 2011 Oct;25(10):3170-4. doi: 10.1007/s00464-011-1681-6. Epub 2011 Apr 13.
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.
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.
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.
Bolus impaction is frequently correlated with eosinophilic esophagitis and reflux esophagitis; therefore, diagnostic workup should include esophageal biopsy sampling.
食管内团块嵌塞是急诊内镜的常见适应证。本研究旨在确定食管内团块嵌塞的最常见病因。
在这项回顾性研究中，分析了 54 例（41 例男性，13 例女性）食管内团块嵌塞患者的数据。评估了团块的类型和位置，以及使用的内镜取出工具。在 54 例患者中的 48 例（89%）中，对食管进行了活检以进行组织学检查。
患者的平均年龄为 53 ± 20 岁。14 例（26%）患者曾有过团块嵌塞史。肉团块（n = 35，65%）是食管梗阻的最常见病因。大多数情况下，团块位于食管的远端（n = 31）或近端（n = 18）。在 22 例（41%）患者中，内镜将团块推入胃中。在大多数其他情况下，使用 5 爪息肉抓钳或鳄口钳可以取出团块，包括异物。团块嵌塞的主要病因分别为嗜酸性食管炎（n = 10）或反流性食管炎伴或不伴消化性狭窄（n = 10）。
团块嵌塞常与嗜酸性食管炎和反流性食管炎相关；因此，诊断性检查应包括食管活检采样。
