Esophageal food impaction: epidemiology and therapy. A retrospective, observational study.
BACKGROUND
Esophageal food impaction is common, but incidence data are lacking and management is controversial. This is a survey of its epidemiology, endoscopic findings, and treatment.


METHODS
A retrospective study was conducted of 194 adults with 223 episodes of esophageal food impaction in a health maintenance organization. Of these, 192 (99%) patients were followed a median of 31 months (range 1-72) post-disimpaction.


RESULTS
The estimated annual incidence rate of episodes was 13.0 per 100,000, and the male:female ratio was 1.7:1. The rate increased with age, especially after the seventh decade. The bolus was meat in 189 (85%) episodes. Flexible esophagoscopy was performed initially in 222 (99.6%) episodes and permitted disimpaction in 218 (98%). The push technique was used alone or in combination with extraction in 186 (84%). Immediate dilation was performed in 172 (79%). There were no major complications. A final diagnosis was made in 171 (88%), including 151 (78%) with a Schatzki's ring or peptic stricture, and the diagnosis had changed during follow-up in 14 (7%). A diagnosis of Schatzki's ring was associated with gender (p = 0.03) and decreased with increasing age (p = 0.003), especially among women.


CONCLUSIONS
Esophageal food impaction is common and can nearly always be treated safely with flexible esophagoscopy, usually with the push technique.
Longstreth
G F
GF
Kaiser Permanente Medical Care Program, Department of San Diego, California, USA.
Longstreth
K J
KJ
Yao
J F
JF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004935:Esophageal Diseases / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*; D004945:Esophagoscopy; D005260:Female; D005502:Food; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies