E D I T O R I A L
P. Monnier
Acute food bolus impaction in the esophagus
Published online: 9 December 2004
Ó Springer-Verlag 2004
In this issue of the European Archives of Oto-Rhino-Laryngology, two articles focus on the initial conserva-tive management of esophageal food bolus impaction in 43 and 37 patients, respectively. In both series, Buscopan was given in slightly more than 80% of the patients in addition to fizzy drinks and other drugs, according to the surgeon’s preference. However, the statistical anal-ysis of the results fails to show any significant difference between the two groups of patients treated with or without Buscopan in one of the articles.
Since the esophageal obstruction resolved spontane-ously over 24 h in more than 50% of the patients in both
series, it seems justified to recommend a 24-h observa-tion period before submitting patients to a therapeutic endoscopy. The only prerequisite is to ascertain that the food bolus does not contain any bony component to avoid the risk of potential perforation of the esophageal wall.
Currently, the contribution of Buscopan in facilitat-ing the passage of the food bolus into the stomach re-mains unproven. This warrants a prospective, randomized, multi-center trial on a larger scale to assess precisely its usefulness in this indication.
P. Monnier
Department of Otolaryngology and Head and Neck Surgery, University Hospital CHUV, 1011 Lausanne, Switzerland Tel.: +41-21-3142700
Fax: +41-21-3142706
Eur Arch Otorhinolaryngol (2005) 262: 523 DOI 10.1007/s00405-004-0851-8
