title: Causes of bolus impaction in the esophagus.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Bolus impaction is frequently correlated with eosinophilic esophagitis and reflux esophagitis; therefore, diagnostic workup should include esophageal biopsy sampling.
authors.affiliation: Department of Internal Medicine I, University Hospital of Regensburg, Regensburg, Germany. Gabriele.Kirchner@Klinik.uni-regensburg.de
authors.forename: Gabriele I
authors.initials: GI
authors.lastname: Kirchner
authors.forename: Ina
authors.initials: I
authors.lastname: Zuber-Jerger
authors.forename: Esther
authors.initials: E
authors.lastname: Endlicher
authors.forename: Cornelia
authors.initials: C
authors.lastname: Gelbmann
authors.forename: Claudia
authors.initials: C
authors.lastname: Ott
authors.forename: Petra
authors.initials: P
authors.lastname: Ruemmele
authors.forename: Jürgen
authors.initials: J
authors.lastname: Schölmerich
authors.forename: Frank
authors.initials: F
authors.lastname: Klebl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D057765:Eosinophilic Esophagitis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D004940:Esophageal Stenosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004945:Esophagoscopy; D004947:Esophagus; D005260:Female; D005547:Foreign Bodies / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies