S2116 Esophageal Food Bolus Impaction Treated With Transnasal Endoscopy in a Patient With Eosinophilic Esophagitis and Trismus Pseudocamptodactyly

Background. The relation of esophageal food bolus impaction (FBI) to eosinophilic esophagitis (EoE) and lymphocytic esophagitis (LyE) is unclear. The aim of this study was to determine the prevalence of EoE and LyE among adults with FBI.Methods. In this retrospective study we analyzed data from all patients referred for gastroscopy during the past 5 years, because of a present or recent episode of FBI.Results. We found 238 patients with FBI (median age 51 (17–96), 71% males). Endoscopic therapy was required in 143 patients. Esophageal biopsies were obtained in 185 (78%) patients. All biopsies were assessed for numbers of eosinophils and lymphocytes. EoE was found in 18% of patients who underwent biopsy. We found 41 patients (22%) who fulfilled the criteria for both EoE and LyE (EoE/LyE). LyE was found in the 9% of patients with FBI. EoE together with EoE/LyE was the leading cause of FBI in patients ≤50 years (64%). GERD was the leading cause of FBI among patients older than 50 years (42%).Conclusions. Our study showed that EoE was the leading cause of FBI in particular among young adults. Our study highlights the need for esophageal biopsies in any patient with FBI.

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S0381 Incidence and Seasonal Variation of Food Bolus Impaction in Patients With Underlying Eosinophilic Esophagitis

The American Journal of Gastroenterology ◽

10.14309/01.ajg.0000703572.61294.46 ◽

2020 ◽

Vol 115 (1) ◽

pp. S188-S189

Author(s):

Michael Massaro ◽

Sujan Ravi ◽

Kimberly Martin ◽

Dane Johnson ◽

James Callaway

Keyword(s):

Seasonal Variation ◽

Eosinophilic Esophagitis ◽

Food Bolus ◽

Food Bolus Impaction ◽

Bolus Impaction

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High-definition-iSCAN virtual chromoendoscopy has high sensitivity and specificity for the diagnosis of eosinophilic esophagitis

Endoscopy International Open ◽

10.1055/s-0043-111591 ◽

2017 ◽

Vol 05 (07) ◽

pp. E613-E621 ◽

Cited By ~ 1

Author(s):

Eustace Gregory ◽

Miriam Fort Gasia ◽

Xianyong Gui ◽

Subrata Ghosh ◽

Marietta Iacucci

Keyword(s):

Sensitivity And Specificity ◽

Eosinophilic Esophagitis ◽

Predictive Value ◽

Good Accuracy ◽

High Sensitivity ◽

Food Bolus ◽

High Definition ◽

Virtual Chromoendoscopy ◽

Food Bolus Impaction ◽

Bolus Impaction

Abstract Background and study aims A major challenge in eosinophilic esophagitis (EoE) is disease recognition during endoscopy as there are no pathognomonic findings. We aimed to determine the utility of high-definition (HD) iSCAN virtual chromoendoscopy (VC) in diagnosis of EoE. Patients and methods One hundred eighty-nine consecutive patients presenting with dysphagia or food bolus impaction were assessed using HD-iSCAN VC (Pentax, Japan) with biopsies from distal, mid, upper esophagus and from furrows where visible. Results Of 189 patients, 45 (23.8 %, male = 29, median age 40y) had a histological diagnosis of EoE; 73.3 % of the patients were newly diagnosed. iSCAN endoscopic features of EoE were linear furrows (91 %), edema (77.8 %), rings or tracheal appearance (73.3 %), whitish exudates (26.6 %) and narrowing or stricture (5 %). One patient (2.2 %) had all 5 endoscopic features. Ten patients (22.2 %) had linear furrows, edema,rings or tracheal appearance and whitish exudates on iSCAN, with a positive predictive value (PPV) 100 % (95 % CI 69.1 %-100 %) and negative predictive value (NPV) 80.4 % (95 % CI 73.9 %-86 %). Thirteen patients (29 %) presented with linear furrows, edema and rings or tracheal appearance on iSCAN, with a PPV 100 % (95 % CI 75.3 %-100 %) and NPV 81.8 % (95 % CI 75.3 %-87.2 %). Six patients (13.3 %) had furrows and edema and 6 patients (13.3 %) had furrows and rings or tracheal appearance on iSCAN, with a PPV 100 % (95 % CI 54.1 %-100 %) and NPV 78.69 % (95 % CI 72 %-84.4 %), respectively. The sensitivity and specificity of HD-iSCAN endoscopy were 97.62 % (95 % CI 87.43 %-99.94 %) and 89.58 % (95 % CI 83.40 %-94.05 %). The accuracy of HD-iSCAN endoscopy was 92.47 % (95 % CI 87.67 %-95.56 %). Conclusion HD-iSCAN endoscopy is sensitive and specific with good accuracy for EoE diagnosis. Linear furrows, edema and tracheal appearance were the most common findings and these 3 endoscopic features had a high predictive value for diagnosis of EoE.

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