Eosinophilic esophagitis: analysis of food impaction and perforation in 251 adolescent and adult patients

Straumann, Alex; Bussmann, Christian; Zuber, Markus; Vannini, Simone; Simon, Hans-Uwe; Schoepfer, Alain (2008). Eosinophilic esophagitis: analysis of food impaction and perforation in 251 adolescent and adult patients. Clinical gastroenterology and hepatology, 6(5), pp. 598-600. Philadelphia, Pa.: Elsevier 10.1016/j.cgh.2008.02.003

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BACKGROUND ; AIMS: Eosinophilic esophagitis is a rapidly emerging, chronic inflammatory disorder. Prolonged inflammation evokes structural alterations and a fragile esophageal wall prone to perforation/rupture and food impaction. This report assesses the risk of spontaneously arising and procedure-induced complications and proposes practical recommendations. METHODS: The Swiss Esophageal Esophagitis Database documented 251 confirmed cases. A chart review identified which patients had required endoscopic bolus removal and/or experienced transmural esophageal perforation/rupture. In addition, a MEDLINE search for "eosinophilic esophagitis" with "esophageal perforation" or "esophageal rupture" was undertaken. RESULTS: During an 18-year period, 87 patients (34.7%) experienced 134 food impactions requiring flexible (124, 92.5%) or rigid (10, 7.5%) endoscopic bolus removal. Transmural perforation occurred in 20% (2/10) of rigid procedures, and 1 esophageal rupture (Boerhaave's syndrome) was observed. CONCLUSIONS: Bolus removal by rigid endoscopy is a high-risk procedure and should be avoided in eosinophilic esophagitis patients who require a gentler approach. Whether food impaction and esophageal wall remodeling can be prevented with anti-inflammatory medication is still undetermined. All Boerhaave's syndrome cases should be evaluated for underlying eosinophilic esophagitis.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Gastroenterology 04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Pharmacology
UniBE Contributor:	Vannini, Simone, Simon, Hans-Uwe, Schöpfer, Alain
ISSN:	1542-3565
ISBN:	18407800
Publisher:	Elsevier
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 15:03
Last Modified:	05 Dec 2022 14:19
Publisher DOI:	10.1016/j.cgh.2008.02.003
PubMed ID:	18407800
Web of Science ID:	000255806200022
URI:	https://boris.unibe.ch/id/eprint/27548 (FactScience: 108789)