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Obri MS, Samad M, Alhaj S, Chaudhary A, Rehman S, Ramzi Almajed M, Rose C, Schultz L, Harris K, Suresh S. Timing of Endoscopic Intervention for Esophageal Food Impaction and Its Impact on Patient Outcomes. Dig Dis Sci 2024:10.1007/s10620-024-08600-9. [PMID: 39298049 DOI: 10.1007/s10620-024-08600-9] [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: 03/31/2024] [Accepted: 08/18/2024] [Indexed: 09/21/2024]
Abstract
INTRODUCTION Esophageal food impaction (EFI) is a common complaint of patients presenting to the emergency department. EFI requires urgent evaluation by the gastroenterology service and often necessitates esophagogastroduodenoscopy (EGD) for management. Timing of EGD in patients with EFI that does not improve with medical management remains a point of contention. We aim to evaluate outcomes of EFI in the context of time to intervention. METHODS A retrospective cohort study was performed among patients who presented to a multicenter health system with EFI between 2018 and 2022. Patients with EFI that did not resolve after medical management and required EGD were included. Outcome analysis evaluated rates of complications and hospitalizations. RESULTS Two hundred eighty sis unique patient presentations were included. 175 (61.2%) of patients underwent EGD within six hours of presentation, 59 (20.6%) underwent EGD six to twelve hours after presentation, and 52 (18.2%) underwent EGD beyond twelve hours after presentation. Complication rates did not differ between patients depending on timing of EGD (p = 1.000). Admission rates were higher among patients in whom EGD was performed longer after presentation (p = 0.003). Complication rates were higher among patients with advanced age (p = 0.037), prior impaction (p = 0.004), and those who have not received glucagon (p = 0.007). CONCLUSION Timing of EGD after presentation in patients with EFI was not associated with a difference in complication rates. Delayed intervention was associated with a higher rate of hospitalization which should be taken into consideration when assessing the cost of EFI to the healthcare system.
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Affiliation(s)
- Mark S Obri
- Department of Internal Medicine, Henry Ford Hospital, Detroit, USA.
- Division of Gastroenterology and Hepatology, Henry Ford Hospital, Detroit, USA.
| | - Momin Samad
- Department of Internal Medicine, Henry Ford Hospital, Detroit, USA
- Division of Gastroenterology and Hepatology, Henry Ford Hospital, Detroit, USA
| | - Suhib Alhaj
- Department of Internal Medicine, Henry Ford Hospital, Detroit, USA
- Division of Gastroenterology and Hepatology, Henry Ford Hospital, Detroit, USA
| | - Ammad Chaudhary
- Department of Internal Medicine, Henry Ford Hospital, Detroit, USA
| | - Sheema Rehman
- Department of Internal Medicine, Henry Ford Hospital, Detroit, USA
- Division of Gastroenterology and Hepatology, Henry Ford Hospital, Detroit, USA
| | - M Ramzi Almajed
- Department of Internal Medicine, Henry Ford Hospital, Detroit, USA
- Division of Gastroenterology and Hepatology, Henry Ford Hospital, Detroit, USA
| | - Courtney Rose
- Department of Internal Medicine, Henry Ford Hospital, Detroit, USA
- Division of Gastroenterology and Hepatology, Henry Ford Hospital, Detroit, USA
| | - Lonni Schultz
- Department of Internal Medicine, Henry Ford Hospital, Detroit, USA
- Division of Gastroenterology and Hepatology, Henry Ford Hospital, Detroit, USA
| | - Kevin Harris
- Department of Internal Medicine, Henry Ford Hospital, Detroit, USA
- Division of Gastroenterology and Hepatology, Henry Ford Hospital, Detroit, USA
| | - Suraj Suresh
- Department of Internal Medicine, Henry Ford Hospital, Detroit, USA
- Division of Gastroenterology and Hepatology, Henry Ford Hospital, Detroit, USA
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Nishizawa T, Toyoshima O, Yoshida S, Uekura C, Kurokawa K, Munkhjargal M, Obata M, Yamada T, Fujishiro M, Ebinuma H, Suzuki H. TXI (Texture and Color Enhancement Imaging) for Serrated Colorectal Lesions. J Clin Med 2021; 11:jcm11010119. [PMID: 35011860 PMCID: PMC8745100 DOI: 10.3390/jcm11010119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/19/2021] [Accepted: 12/24/2021] [Indexed: 12/13/2022] Open
Abstract
Background and aim: Olympus Corporation released the texture and color enhancement imaging (TXI) technology as a novel image-enhancing endoscopic technique. We investigated the effectiveness of TXI in the imaging of serrated colorectal polyps, including sessile serrated lesions (SSLs). Methods: Serrated colorectal polyps were observed using white light imaging (WLI), TXI, narrow-band imaging (NBI), and chromoendoscopy with and without magnification. Serrated polyps were histologically confirmed. TXI was compared with WLI, NBI, and chromoendoscopy for the visibility of the lesions without magnification and for that of the vessel and surface patterns with magnification. Three expert endoscopists evaluated the visibility scores, which were classified from 1 to 4. Results: Twenty-nine consecutive serrated polyps were evaluated. In the visibility score without magnification, TXI was significantly superior to WLI but inferior to chromoendoscopy in the imaging of serrated polyps and the sub-analysis of SSLs. In the visibility score for vessel patterns with magnification, TXI was significantly superior to WLI and chromoendoscopy in the imaging of serrated polyps and the sub-analysis of SSLs. In the visibility score for surface patterns with magnification, TXI was significantly superior to WLI but inferior to NBI in serrated polyps and in the sub-analysis of SSLs and hyperplastic polyps. Conclusions: TXI provided higher visibility than did WLI for serrated, colorectal polyps, including SSLs.
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Affiliation(s)
- Toshihiro Nishizawa
- Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo 157-0066, Japan; (T.N.); (O.T.); (S.Y.); (C.U.); (K.K.); (M.O.); (T.Y.)
- Department of Gastroenterology and Hepatology, International University of Health and Welfare, Narita Hospital, Narita 286-8520, Japan; (M.M.); (H.E.)
| | - Osamu Toyoshima
- Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo 157-0066, Japan; (T.N.); (O.T.); (S.Y.); (C.U.); (K.K.); (M.O.); (T.Y.)
| | - Shuntaro Yoshida
- Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo 157-0066, Japan; (T.N.); (O.T.); (S.Y.); (C.U.); (K.K.); (M.O.); (T.Y.)
| | - Chie Uekura
- Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo 157-0066, Japan; (T.N.); (O.T.); (S.Y.); (C.U.); (K.K.); (M.O.); (T.Y.)
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan;
| | - Ken Kurokawa
- Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo 157-0066, Japan; (T.N.); (O.T.); (S.Y.); (C.U.); (K.K.); (M.O.); (T.Y.)
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan;
| | - Munkhbayar Munkhjargal
- Department of Gastroenterology and Hepatology, International University of Health and Welfare, Narita Hospital, Narita 286-8520, Japan; (M.M.); (H.E.)
| | - Miho Obata
- Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo 157-0066, Japan; (T.N.); (O.T.); (S.Y.); (C.U.); (K.K.); (M.O.); (T.Y.)
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan;
| | - Tomoharu Yamada
- Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo 157-0066, Japan; (T.N.); (O.T.); (S.Y.); (C.U.); (K.K.); (M.O.); (T.Y.)
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan;
| | - Mitsuhiro Fujishiro
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan;
| | - Hirotoshi Ebinuma
- Department of Gastroenterology and Hepatology, International University of Health and Welfare, Narita Hospital, Narita 286-8520, Japan; (M.M.); (H.E.)
| | - Hidekazu Suzuki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Isehara 259-1193, Japan
- Correspondence: ; Tel.: +81-463-93-1121
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