title: The management of oesophageal soft food bolus obstruction: a systematic review.
abstract: BACKGROUND
  Oesophageal soft food bolus obstruction (OSFBO) is a surgical emergency. However, no national guidelines exist regarding its management. This paper systematically reviews the literature with respect to the management of OSFBO.
  
  
  METHODS
  Relevant studies included were identified from the the Cochrane Library, the National Center for Biotechnology Information and the US National Library of Medicine resources. A systematic review was performed on 8 November 2010.
  
  
  RESULTS
  This systematic review of the management of OSFBO shows no evidence that any medical intervention is more effective than a 'watch and wait' policy in enabling spontaneous disimpaction. Furthermore, the use of hyoscine butylbromide for OSFBO probably stems from a misquoted textbook. Surgical removal of an OSFBO is effective but not without potential risk. There is some evidence to support surgical intervention within 24 hours to prevent complications deriving from the initial obstruction.
  
  
  CONCLUSIONS
  There is a need for large double-blind, randomised, placebo controlled trials of drugs used in the medical management of OSFBO. Until the results from such trials are available, the treatment of OSFBO will remain based on inconsistent clinical judgement.
authors.affiliation: Cardiff University School of Medicine, Cardiff, UK. dan.leopard@gmail.com
authors.forename: D
authors.initials: D
authors.lastname: Leopard
authors.forename: S
authors.initials: S
authors.lastname: Fishpool
authors.forename: S
authors.initials: S
authors.lastname: Winter
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D002086:Butylscopolammonium Bromide / Q000627:therapeutic use; D003680:Deglutition Disorders / Q000209:etiology; D004940:Esophageal Stenosis / Q000628:therapy*; D004945:Esophagoscopy / Q000009:adverse effects / Q000379:methods; D004947:Esophagus; D005502:Food; D005547:Foreign Bodies / Q000628:therapy*; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D005934:Glucagon / Q000627:therapeutic use; D006801:Humans; D010276:Parasympatholytics / Q000627:therapeutic use; D057832:Watchful Waiting
chemical_list: D000701:Analgesics, Opioid; D005765:Gastrointestinal Agents; D010276:Parasympatholytics; D001569:Benzodiazepines; D002086:Butylscopolammonium Bromide; D005934:Glucagon