scholarly journals A review of optimal evaluation and treatment of suspected esophageal food impaction

2020 ◽  
Author(s):  
MeNore Lake ◽  
David Smoot ◽  
Peter O’Halloran ◽  
Michael Shortsleeve
Keyword(s):  
Aortic Arch ◽  
Retrospective Chart Review ◽  
Clinical Consequence ◽  
Food Impaction ◽  
Common Diagnosis ◽  
Esophageal Food Impaction ◽  
Efficient Alternative ◽  
Cost Efficient ◽  
A Minor ◽  
Optimal Evaluation

Abstract Fluoroscopy-guided esophageal disimpaction of ingested food is a safe, effective, and cost-efficient alternative to endoscopically guided disimpaction. Patients with suspected esophageal impaction usually require fluoroscopy to confirm the diagnosis and determine the level of obstruction, which guides further management. Proximal esophageal food impactions at or near the cricopharyngeus muscle require an ENT intervention. Food impactions from the cervical esophagus to the aortic arch require a GI intervention. Obstructions distal to the aortic arch can usually be managed by the radiologist with a fluoroscopy-guided disimpaction. The use of intravenous glucagon to relax the mid and distal esophageal smooth muscle, combined with an effervescent agent, and water comprises this “combination” therapy to relieve an acute esophageal food impaction. This paper reviews the indications, contraindications, technique, and 32 years of experience with fluoroscopy-guided esophageal disimpaction at our institution. A retrospective chart review of our experience includes 252 patients with a 56% success rate that obviated more expensive and invasive procedures. Only one complication of a minor mucosal tear of no clinical consequence was encountered. Radiologists should be familiar with the presentation and management of this common diagnosis.

scholarly journals 394 Esophageal Food Impaction - A Retrospective Chart Review

2019 ◽  
Vol 114 (1) ◽  
pp. S230-S231
Author(s):  
Dhineshreddy Gurala ◽  
Jobin Philipose ◽  
Abhishek Polavarapu ◽  
Vivek Gumaste
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Food Impaction ◽  
Esophageal Food Impaction

scholarly journals Esophageal Food Impaction: A Retrospective Chart Review

2021 ◽  
Vol 14 (3) ◽  
pp. 173-178
Author(s):  
Dhineshreddy Gurala ◽  
Abhishek Polavarapu ◽  
Jobin Philipose ◽  
Shivantha Amarnath ◽  
Akshay Avula ◽  
...  
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Food Impaction ◽  
Esophageal Food Impaction

Empiric proton pump inhibitor therapy after esophageal food impaction may mask eosinophilic esophagitis diagnosis at follow-up

2021 ◽  
Author(s):  
Luke Hillman ◽  
Sarah Donohue ◽  
Aimee Teo Broman ◽  
Patrick Hoversten ◽  
Eric Gaumnitz ◽  
...  
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Eosinophilic Esophagitis ◽  
Empiric Therapy ◽  
Proton Pump Inhibitor Therapy ◽  
Significant Heterogeneity ◽  
Food Impaction ◽  
Esophageal Food Impaction ◽  
The Impact

Summary Esophageal food impaction (EFI) is often the first presentation for patients with eosinophilic esophagitis (EoE); however, there is significant heterogeneity in the management of EFI. We aimed to study the impact of EFI management, particularly post-EFI medication prescriptions on EoE diagnosis, follow-up, and recurrence in patients with endoscopic features of EoE. In our retrospective study, adults presenting between 2007 and 2017 with EFI requiring endoscopic dis-impaction with endoscopic features of EoE (furrows, rings, and/or exudates) were included. We examined the impact of demographics and EFI management on EoE diagnosis, follow-up (esophagogastroduodenoscopy [EGD] or clinic visit within 6 months), and recurrence. We identified 164 cases of EFI due to suspected EoE. Biopsy was performed in 68 patients (41.5%), and 144 patients (87.8%) were placed on proton pump inhibitor (PPI) and/or swallow corticosteroids after EFI, including 88.5% of those not biopsied. PPI use at time of biopsy was negatively associated with EoE diagnosis (odds ratio: 0.39, confidence interval: 0.17–0.85). Sixty-one (37.4%) patients were lost to follow-up at 6 months. Recurrent EFI at 1 year occurred in 3.7% of patients. Medications, most commonly PPI, are frequently prescribed after EFI when the endoscopic features of EoE are present, which may mask the diagnosis of EoE on follow-up EGD. We estimated that for every five patients biopsied on PPI, one case of EoE is masked. As recurrent EFI within 1 year is uncommon, empiric therapy should be avoided until diagnostic biopsies are obtained. Further efforts to reduce loss to follow-up after EFI are also needed.

scholarly journals Multiuse of Disposable Microsurgical Instruments as a Cost-Efficient Alternative for Training and Research

2017 ◽  
Vol 5 (5) ◽  
pp. e1320 ◽  
Author(s):  
Martin Aman ◽  
Matthias E. Sporer ◽  
Otto Riedl ◽  
Wei-Te Wang ◽  
Anne Kramer ◽  
...  
Keyword(s):  
Training And Research ◽  
Efficient Alternative ◽  
Cost Efficient

Video-Assisted Thoracoscopic Division of Vascular Rings in Pediatric Patients

2005 ◽  
Vol 71 (4) ◽  
pp. 289-291 ◽  
Author(s):  
Curt S. Koontz ◽  
Amina Bhatia ◽  
Joe Forbess ◽  
Mark L. Wulkan
Keyword(s):  
Aortic Arch ◽  
Pediatric Patients ◽  
Vascular Ring ◽  
Operating Time ◽  
Surgical Techniques ◽  
Retrospective Chart Review ◽  
Ligamentum Arteriosum ◽  
Vascular Rings ◽  
Computed Tomographic ◽  
Video Assisted

Vascular rings are usually repaired via left thoracotomy. We report our series of pediatric patients with vascular rings that were repaired thoracoscopically. From February 2002 to September 2004, 13 patients underwent video-assisted thoracoscopic surgical techniques (VATS) division of their vascular ring. Chest magnetic resonance arterography (MRA) and/or computed tomographic arteriography (CTA) were used to evaluate the vascular ring in most patients. Patients were chosen for VATS repair based on surgeon's choice and type of vascular ring. Data are expressed as mean ± SD. The Children's Healthcare of Atlanta Institutional Review Board approved this retrospective chart review. Age and weight was 1.5 ± 1.8 years (range: 4 months–17 years) and 16.0 ± 12.5 kg (range: 6.0–22.1 kg), respectively (n = 13). Associated diseases included congenital heart disease (n = 2). Symptoms included respiratory complaints (n = 6), dysphagia (n = 2), dysphagia and shortness of breath (n = 1), pneumonia (n = 2), tracheal deviation (n = 1), and one patient was asymptomatic. Vascular ring types included double aortic arch (n = 4) and right aortic arch with an aberrant left subclavian artery and a left ligamentum arteriosum (n = 9). Operating time was 70 ± 20 minutes (range: 46–122 minutes). One patient had to be opened because of a large arch. Length of stay was 1.9 ± 0.9 days (range: 1–3 days). There were no complications, and all patients improved clinically at follow-up. Thoracoscopic repair of certain types of vascular rings seems to be safe and effective in children. More patients, however, need to be studied.

scholarly journals Development of a composite friction modifier with carbon nanotubes for applications at the wheel–rail interface

2020 ◽  
Vol 29 ◽  
pp. 2633366X2093001
Author(s):  
Juan Camilo Vélez ◽  
Jesús Antonio Carlos Cornelio ◽  
Robinson Buitrago Sierra ◽  
Juan Felipe Santa ◽  
Lina Marcela Hoyos-Palacio ◽  
...  
Keyword(s):  
Carbon Nanotubes ◽  
Traction Force ◽  
Solid Lubricants ◽  
Total Solid ◽  
Transportation Industry ◽  
Railway Transportation ◽  
Friction Modifier ◽  
Total Mass Loss ◽  
Efficient Alternative ◽  
Cost Efficient

Wear of wheels and rails is a major problem in railway transportation industry. Solid lubricants constitute a cost-efficient alternative to control wear and friction at the wheel–rail interface, especially when a fine-tuned balance between traction force and energy consumption is sought. In this work, composite friction modifiers (CFMs) composed of a vinyl ester matrix reinforced with molybdenum disulfide and carbon nanotubes were developed. The total solid additive content was less than a half in comparison with a commercial product available on the market, which was used as a reference. A benchmarking study of the CFM was carried out by means of tribological tests in a twin-disc machine at a contact pressure of 1.1 GPa and different slip values. The results indicated that the developed CFM reduce coefficient of traction by 10% compared to unlubricated conditions that is similar to the reference. However, the total mass loss of steel components due to wear under CFM lubrication was lower than in the reference test.

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