Kilroe Matthew J, McAtee Kyle J, McReynolds Tamara M
Emergency Medicine Residency Program, Carl R. Darnall Army Medical Center, Fort Hood, Texas.
J Emerg Med. 2024 Jan;66(1):e27-e28. doi: 10.1016/j.jemermed.2023.06.016. Epub 2023 Jul 6.
Emergency department (ED) management of esophageal food impaction without high-grade obstruction is highly variable, without definitive and validated interventions being supported in medical literature.
We discuss a 34-year-old male patient with diagnosis of eosinophilic esophagitis and history of multiple food impactions presenting to the ED with a food impaction. Based on a known esophageal history with repeated failure of pharmacologic interventions, the patient was submitted to a new conservative treatment of warm water drinking. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case report suggests warm water ingestion as a novel, safe, and successful treatment method in the management of esophageal food bolus impaction. As a conservative treatment not deviating greatly from current ED treatment options, it can reduce patient length of stay and decrease exposure to potential morbidity via invasive endoscopic or surgical intervention. It should be further investigated and validated with a large cohort study.
急诊科对无高度梗阻的食管食物嵌塞的处理差异很大,医学文献中没有支持明确且经过验证的干预措施。
我们讨论一名34岁男性患者,诊断为嗜酸性食管炎,有多次食物嵌塞病史,此次因食物嵌塞就诊于急诊科。基于已知的食管病史且药物干预多次失败,该患者接受了饮用温水的新保守治疗。急诊科医生为何应了解此情况?:本病例报告提示饮用温水是食管食物团块嵌塞管理中一种新颖、安全且成功的治疗方法。作为一种与当前急诊科治疗选择差异不大的保守治疗方法,它可以缩短患者住院时间,并减少因侵入性内镜或手术干预导致的潜在发病率。应通过大型队列研究进一步研究和验证。