ACUTE FOOD BOLUS IMPACTION - ETIOLOGY AND MANAGEMENT

A prospective study into the aetiology of acute food bolus obstruction (AFBO) was carried out on 17 consecutive patients who presented with this complaint. There were nine males and eight females. Twelve patien ts (71 per cent) had symptoms of oesophageal disease and 10 patients ( 59 per cent) had prior food bolus obstruction. Investigations included endoscopy, barium swallow. oesophageal pH and manometry studies. Evid ence of oesophageal pathology was found in 12/14 (86 per cent) of pati ents investigated. No patients had malignancy and the most common abno rmality, gastroesophageal reflux (GOR) was found in eight out of 14 (5 7 per cent) of cases. Oesophageal dysmotility was seen in five out of 12 (42 per cent) patients who had manometric studies. With such a high incidence of recurrence of AFBO, we suggest that patients with this c ondition be investigated to exclude malignancy and to identify benign oesophageal pathology using techniques such as oesophageal pH and mano metry. Appropriate treatment of oesophageal disease may help prevent r ecurrence of this distressing condition.