Seasonal recurrence of food bolus obstruction in eosinophilic esophagitis

2015 ◽  
Vol 45 (9) ◽  
pp. 939-943 ◽  
Author(s):  
H. L. Philpott ◽  
S. Nandurkar ◽  
F. Thien ◽  
S. Bloom ◽  
E. Lin ◽  
...  
Keyword(s):  
Eosinophilic Esophagitis ◽  
Food Bolus

scholarly journals Death Resulting from Pneumocephalus Complicating Endoscopic Food Bolus Retrieval in a Patient with Eosinophilic Esophagitis

2016 ◽  
Vol 6 (4) ◽  
pp. 703-708 ◽  
Author(s):  
Amy K. Fuhs ◽  
Joseph A. Prahlow
Keyword(s):  
Eosinophilic Esophagitis ◽  
Rare Complication ◽  
Flexible Endoscopy ◽  
Brain Parenchyma ◽  
Esophageal Mucosa ◽  
Food Bolus ◽  
Patient Death ◽  
Injury Death ◽  
Computed Tomography Scanning ◽  
The Brain

Pneumocephalus is a rare complication of esophagogastroduodenoscopy (EGD), but existing literature does not discuss pneumocephalus surrounding endoscopic food bolus retrieval. We present a death involving pneumocephalus complicating endoscopic food removal from the esophagus. A 40-year-old man presented with dysphagia and suprasternal discomfort 12 hours following chicken ingestion. On flexible endoscopy, chicken was visualized in the distal esophagus. After successful retrieval, a mucosal laceration was noted where the chicken had been lodged. He was unarousable following the procedure and was emergently transported to a hospital, where computed tomography scanning showed pneumocephalus. He was later declared brain dead. The case was referred for medicolegal autopsy. The brain was examined first, revealing rare air bubbles within meningeal vessels and numerous, diffuse petechiae-like hemorrhages within the brain parenchyma. The esophageal mucosa had focal discoloration and a partial thickness laceration; microscopic examination revealed eosinophilic esophagitis. Eosinophilic esophagitis is a known risk factor for food bolus impaction and should be suspected in such patients. Pneumocephalus is a rare possible complication of EGD for food bolus retrieval. In patients unresponsive after endoscopy, radiographic detection of potential pneumocephalus should be encouraged to enable timely therapy and improved outcomes, or to supplement autopsy in the event of patient death. Forensic pathologists should understand that pneumocephalus is a potential mechanism of injury/death in patients experiencing esophageal trauma, including injury incurred during EGD.

Changing epidemiology of food bolus impaction: Is eosinophilic esophagitis to blame?

2013 ◽  
Vol 28 (6) ◽  
pp. 963-966 ◽  
Author(s):  
Venkat N Mahesh ◽  
Richard H Holloway ◽  
Nam Quoc Nguyen
Keyword(s):  
Eosinophilic Esophagitis ◽  
Food Bolus ◽  
Food Bolus Impaction ◽  
Bolus Impaction

scholarly journals Recent Advances in the Recognition and Management of Eosinophilic Esophagitis

2015 ◽  
Vol 29 (5) ◽  
pp. 237-240 ◽  
Author(s):  
Gregory Eustace ◽  
Xianyong Gui ◽  
Marietta Iacucci
Keyword(s):  
Proton Pump ◽  
Eosinophilic Esophagitis ◽  
Targeted Therapies ◽  
Multidisciplinary Approach ◽  
Topical Steroid ◽  
Dietary Therapy ◽  
Immunological Reaction ◽  
Endoscopic Dilation ◽  
Food Bolus ◽  
Food Items

The incidence and recognition of eosinophilic esophagitis is increasing. Pathophysiological understanding of eosinophilic esophagitis is improving and an immunological reaction to ingested food is likely to play a significant role. Patients present with dysphagia and food bolus obstruction. Both histological and endoscopic criteria have been developed and validated. Dietary therapy, topical steroid therapy, proton pump inhibitors and endoscopic dilation are the main approaches to therapy; however, novel targeted therapies are being developed. Among the food items commonly implicated are wheat, dairy, nuts, soy, shellfish and eggs. A multidisciplinary approach to management in dedicated clinics may yield the best results.

scholarly journals Esophageal Intramural Pseudodiverticulosis and Concomitant Eosinophilic Esophagitis: A Case Series

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Michael A. Scaffidi ◽  
Ankit Garg ◽  
Brandon Ro ◽  
Christopher Wang ◽  
Tony T. C. Yang ◽  
...  
Keyword(s):  
Eosinophilic Esophagitis ◽  
Case Series ◽  
Clinical Information ◽  
Esophageal Wall ◽  
Food Bolus ◽  
First Case ◽  
Academic Center ◽  
Potential Association ◽  
Esophageal Intramural Pseudodiverticulosis ◽  
Characteristic Features

Background. Esophageal intramural pseudodiverticulosis (EIPD) is an idiopathic benign chronic disease characterized by flask-like outpouchings of the esophageal wall. It is unknown whether there is a genuine association between EIPD and eosinophilic esophagitis (EoE).Aims. To investigate a possible relationship between EIPD and EoE.Methods. Patients with radiographic or endoscopic evidence of pseudodiverticulosis were identified from the database at a single academic center. Cases were analyzed in three areas: clinical information, endoscopic findings, and course.Results. Sixteen cases of esophageal pseudodiverticulosis were identified. Five patients had histologic evidence of eosinophilic esophagitis. Patients with EoE had pseudodiverticula in the mid-to-distal esophagus while those with EIPD had pseudodiverticula predominantly in the proximal esophagus (p<0.001). EoE with pseudodiverticulosis occurred in younger patients (p<0.019). Food bolus obstructions were more common in patients with EoE and pseudodiverticulosis than in EIPD (p<0.034).Conclusions. This is the first case series supporting a potential association between EoE and pseudodiverticulosis. We also identify characteristic features of pseudodiverticulosis that may raise clinical suspicion of underlying eosinophilic esophagitis.

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

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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