1
|
Heise J, Kreysel C, Blank M, Euler P, Melchior I, Johnen M, Planker M, Ballauff A, Czypull M, Frieling T. [Bolus obstruction within the esophagus - an analysis over 5 years]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2023; 61:1603-1607. [PMID: 36990446 DOI: 10.1055/a-2029-6468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
BACKGROUND The removal of bolus impaction within the esophagus is an indication for emergency endoscopy. The current guideline of the European Society of Gastrointestinal Endoscopy (ESGE) recommends gently pushing the bolus into the stomach. This view is discerned by many endoscopists because of the increased risk of complications. In addition, the use of an endoscopic cap for bolus removal is not mentioned. MATERIAL AND METHODS In a retrospective analysis from 2017 to 2021 we investigated 66 adults and 11 children with acute bolus impaction within the esophagus. RESULTS Eosinophilic esophagitis, reflux esophagitic /peptic stenosis and Schatzki Ring caused 57.6%, esophageal and bronchial carcinoma 18%, esophageal motility disorders 4.5%, Zenkers diverticulum 1.5% and radiation esophagitis 1.5% of the bolus obstructions. The reason remained unclear in 16.7% of the cases. The spectrum was comparable in children with additional 2 cases with esophageal atresia and stenosis. The reason was unclear in 2 cases. Removal of bolus impaction was successful in 92.4% in adults and 100% in children. Bolus obstruction in adults was successfully removed solely by endoscopic cap in 57.6% and 75% in children. Pushing the bolus into the stomach without disintegration was possible in only 9% of cases. CONCLUSION Flexible endoscopy is an effective ermergency intervention for removal of bolus obstruction within the esophagus. Uncontrolled pushing the bolus into the stomach without view cannot be recommended. An endoscopic cap is a good extension for safe bolus removal.
Collapse
Affiliation(s)
- Jürgen Heise
- Medizinische Klinik II, HELIOS Klinikum Krefeld, Krefeld, Germany
| | | | - Michael Blank
- Medizinische Klinik II, HELIOS Klinikum Krefeld, Krefeld, Germany
| | - Philipp Euler
- Medizinische Klinik II, HELIOS Klinikum Krefeld, Krefeld, Germany
| | - Ilka Melchior
- Medizinische Klinik II, HELIOS Klinikum Krefeld, Krefeld, Germany
| | - Michaela Johnen
- Medizinische Klinik II, HELIOS Klinikum Krefeld, Krefeld, Germany
| | - Manfred Planker
- Medizinische Klinik II, HELIOS Klinikum Krefeld, Krefeld, Germany
| | - Antje Ballauff
- Zentrum für Kinder- und Jugendmedizin, HELIOS Klinikum Krefeld, Krefeld, Germany
| | - Martina Czypull
- Medizinische Klinik II, HELIOS Klinikum Krefeld, Krefeld, Germany
| | - Thomas Frieling
- Medizinische Klinik II, HELIOS Klinikum Krefeld, Krefeld, Germany
| |
Collapse
|
2
|
Iqbal U, Yodice M, Ahmed Z, Lee-Smith W, Adler DG, Confer BD. Efficacy of cap-assisted endoscopy for the visualization of the major duodenal papilla: a systematic review and meta-analysis. Gastrointest Endosc 2023; 98:1004-1008. [PMID: 37544335 DOI: 10.1016/j.gie.2023.07.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 07/30/2023] [Accepted: 07/31/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND AND AIMS The current standard of practice is to use a duodenoscope for the evaluation of the major duodenal papilla (MDP). Recently, cap-assisted endoscopy (CAE), which uses a transparent cap at the tip of a standard front-viewing endoscope, has emerged as an alternative. METHODS A systematic literature search was performed in several databases from inception to January 2023 to identify studies evaluating the efficacy of CAE for the evaluation of the MDP. RESULTS Nine studies including 806 patients met our inclusion criteria. The pooled rate of technical success for CAE was 93.2% (95% confidence interval, 85.6-96.9; I2 = 84.6%). A subgroup analysis comparing CAE with a standard endoscope showed higher odds for the evaluation of the MDP with CAE (but not a duodenoscope, which was better than CAE) with an odds ratio of 57.294 (95% confidence interval, 17.767-184.755; I2 = 45.303%). CONCLUSIONS CAE offers a significant advantage with high rates of complete MDP evaluation compared with standard forward-viewing endoscopy. However, CAE is associated with lower rates of success when compared with side-viewing endoscopes.
Collapse
Affiliation(s)
- Umair Iqbal
- Division of Gastroenterology, WellSpan York Hospital, York, Pennsylvania, USA
| | - Michael Yodice
- Division of Internal Medicine, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Zohaib Ahmed
- Department of Gastroenterology, University of Toledo Medical Center, Toledo, Ohio, USA
| | - Wade Lee-Smith
- University Libraries, University of Toledo Medical Center, Toledo, Ohio, USA
| | - Douglas G Adler
- Center for Advanced Therapeutic Endoscopy (CATE), Centura Health, Porter Adventist Hospital, Peak Gastroenterology, Denver, Colorado, USA
| | - Bradley D Confer
- Division of Gastroenterology, Geisinger Medical Center, Danville, Pennsylvania, USA
| |
Collapse
|
3
|
Mahmood S, Tazinkeng N, Holzwanger EA, Igbinedion S, Gabr M, Sawhney MS, Berzin TM, Pleskow DK. Enhanced suction for removal of esophageal food impaction. VIDEOGIE : AN OFFICIAL VIDEO JOURNAL OF THE AMERICAN SOCIETY FOR GASTROINTESTINAL ENDOSCOPY 2023; 8:298-300. [PMID: 37575135 PMCID: PMC10422076 DOI: 10.1016/j.vgie.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Video 1Enhanced suction for removal of esophageal food impaction.
Collapse
Affiliation(s)
- Sultan Mahmood
- Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Nkengeh Tazinkeng
- Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Erik A Holzwanger
- Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Samuel Igbinedion
- Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Moamen Gabr
- Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Mandeep S Sawhney
- Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Tyler M Berzin
- Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Douglas K Pleskow
- Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
4
|
Tarar ZI, Farooq U, Bechtold ML, Ghouri YA. Cap-assisted endoscopy for esophageal foreign bodies: A meta-analysis. World J Meta-Anal 2023; 11:238-246. [DOI: 10.13105/wjma.v11.i5.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Esophageal foreign bodies are common around the world. Newer approaches, such as cap-assisted endoscopy, have been introduced as an alternative to conventional methods. Therefore, we performed a meta-analysis ono cap-assisted endoscopy versus conventional endoscopy for removal of esophageal foreign bodies.
AIM To investigated the effectiveness of cap-assisted endoscopy with conventional endoscopy.
METHODS An extensive literature search was performed (December 2021). For esophageal foreign body removal, cap-assisted endoscopy was compared to conventional endoscopy for procedure time, technical success of the procedure, time of foreign body retrieval, en bloc removal, and adverse event rate using odds ratio and mean difference.
RESULTS Six studies met the inclusion criteria (n = 1305). Higher odds of technical success (P = 0.002) and en bloc removal (P < 0.01) and lower odds of adverse events (P = 0.02) and foreign body removal time (P < 0.01) were observed with cap-assisted endoscopy as compared to conventional techniques.
CONCLUSION For esophageal foreign bodies, the technique of cap-assisted endoscopy demonstrated increased en bloc removal and technical success with decreased time and adverse events as compared to conventional techniques.
Collapse
Affiliation(s)
- Zahid Ijaz Tarar
- Department of Internal Medicine, University of Missouri, Columbia, MO 65212, United States
| | - Umer Farooq
- Department of Medicine, Loyola University, Chicago, IL 60153, United States
| | - Matthew L Bechtold
- Department of Medicine, University of Missouri - Columbia, Columbia, MO 65212, United States
| | - Yezaz A Ghouri
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, United States
| |
Collapse
|
5
|
Sabe R, Hiremath G, Ng K. Endoscopy in Pediatric Eosinophilic Esophagitis. Gastrointest Endosc Clin N Am 2023; 33:323-339. [PMID: 36948749 DOI: 10.1016/j.giec.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
Eosinophilic esophagitis (EoE) is a chronic allergen-mediated clinicopathologic condition that currently requires esophagogastroduodenoscopy with biopsies and histologic evaluation to diagnose and monitor its progress. This state-of-the art review outlines the pathophysiology of EoE, reviews the application of endoscopy as a diagnostic and therapeutic tool, and discusses potential complications related to therapeutic endoscopic interventions. It also introduces recent innovations that can enhance the endoscopist's ability to diagnose and monitor EoE with minimally invasive procedures and perform therapeutic maneuvers more safely and effectively.
Collapse
Affiliation(s)
- Ramy Sabe
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Rainbow Babies and Children's Hospitals, Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106, USA
| | - Girish Hiremath
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, 11226, 2200 Children's Way, Nashville, TN 37232, USA
| | - Kenneth Ng
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Johns Hopkins Children's Center, Johns Hopkins University School of Medicine, 600 North Wolfe Street, CMSC 2-116, Baltimore, MD 21287, USA.
| |
Collapse
|
6
|
Tarar ZI, Farooq U, Bechtold ML, Ghouri YA. Cap-assisted endoscopy for esophageal foreign bodies: A meta-analysis. World J Meta-Anal 2023; 11:38-46. [DOI: 10.13105/wjma.v11.i1.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/11/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Esophageal foreign bodies are common around the world. Newer approaches, such as cap-assisted endoscopy, have been introduced as an alternative to conventional methods. Therefore, we performed a meta-analysis ono cap-assisted endoscopy versus conventional endoscopy for removal of esophageal foreign bodies.
AIM To investigated the effectiveness of cap-assisted endoscopy with conventional endoscopy.
METHODS An extensive literature search was performed (December 2021). For esophageal foreign body removal, cap-assisted endoscopy was compared to conventional endoscopy for procedure time, technical success of the procedure, time of foreign body retrieval, en bloc removal, and adverse event rate using odds ratio and mean difference.
RESULTS Six studies met the inclusion criteria (n = 1305). Higher odds of technical success (P = 0.002) and en bloc removal (P < 0.01) and lower odds of adverse events (P = 0.02) and foreign body removal time (P < 0.01) were observed with cap-assisted endoscopy as compared to conventional techniques.
CONCLUSION For esophageal foreign bodies, the technique of cap-assisted endoscopy demonstrated increased en bloc removal and technical success with decreased time and adverse events as compared to conventional techniques.
Collapse
Affiliation(s)
- Zahid Ijaz Tarar
- Department of Internal Medicine, University of Missouri, Columbia, MO 65212, United States
| | - Umer Farooq
- Department of Medicine, Loyola University, Chicago, IL 60153, United States
| | - Matthew L Bechtold
- Department of Medicine, University of Missouri - Columbia, Columbia, MO 65212, United States
| | - Yezaz A Ghouri
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, United States
| |
Collapse
|
7
|
Ahmed Z, Arif SF, Ong SL, Badal J, Lee-Smith W, Renno A, Alastal Y, Nawras A, Aziz M. Cap-Assisted Endoscopic Esophageal Foreign Body Removal Is Safe and Efficacious Compared to Conventional Methods. Dig Dis Sci 2022; 68:1411-1425. [PMID: 36350475 DOI: 10.1007/s10620-022-07741-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/17/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Esophageal foreign body impaction (FBI) is a commonly encountered gastrointestinal emergency requiring immediate intervention. Foreign bodies can be composed of food, commonly referred to as a "food bolus" (FB), or other matter (non-food). We aim to conduct systematic review and meta-analysis to compare cap-assisted and conventional endoscopic techniques for removal of esophageal FBI. METHODS A comprehensive search technique was utilized to identify studies that used capped endoscopic devices to remove FB or other esophageal foreign bodies. The primary outcomes were the technical success rate, rate of en bloc retrieval, and procedure time. Secondary outcomes were overall adverse events, bleeding, mucosal tears, and perforation. RESULTS Seven studies with a total of 1407 patients were included. The mean patient age was 55.3 (SD ± 7.2) years and 44.8% of patients were male. There were two RCTs and five observational studies among the included studies. The technical success rate was significantly higher in the cap-assisted group compared to the conventional group (OR 3.47, CI 1.68-7.168, I2 = 0%, p = < 0.001), as well as the en bloc retrieval rate (OR 26.90, CI 17.82-40.60, I2 = 0%, p = 0.001). There was a trend towards lower procedural time for the cap-assisted group compared to the conventional group, although the difference did not reach statistical significance (MD - 10.997, CI - 22.78-0.786, I2 = 99.9%, p = 0.06). The overall adverse events were significantly lower in the cap-assisted group compared to the conventional group (OR 0.118, CI 0.018-0.792, I2 = 81.79%, p = 0.02). CONCLUSION The cap-assisted technique has improved efficacy and safety. To confirm these results, larger randomized trials are warranted.
Collapse
Affiliation(s)
- Zohaib Ahmed
- Department of Internal Medicine, University of Toledo Medical Center, Toledo, OH, USA.
| | | | - Stephanie Lin Ong
- University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Joyce Badal
- University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Wade Lee-Smith
- University of Toledo Libraries, University of Toledo, Toledo, OH, USA
| | - Anas Renno
- Division of Gastroenterology and Hepatology, University of Toledo Medical Center, Toledo, OH, USA
| | - Yaseen Alastal
- Division of Gastroenterology and Hepatology, University of Toledo Medical Center, Toledo, OH, USA
| | - Ali Nawras
- Division of Gastroenterology and Hepatology, University of Toledo Medical Center, Toledo, OH, USA
| | - Muhammad Aziz
- Division of Gastroenterology and Hepatology, University of Toledo Medical Center, Toledo, OH, USA
| |
Collapse
|
8
|
Adverse events associated with EGD and EGD-related techniques. Gastrointest Endosc 2022; 96:389-401.e1. [PMID: 35843754 DOI: 10.1016/j.gie.2022.04.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 04/21/2022] [Indexed: 01/10/2023]
|