Posters
Academic Level (Author 1)
Resident
Discipline/Specialty (Author 1)
Internal Medicine
Academic Level (Author 2)
Resident
Discipline/Specialty (Author 2)
Internal Medicine
Academic Level (Author 3)
Resident
Discipline/Specialty (Author 3)
Internal Medicine
Academic Level (Author 4)
Resident
Discipline/Specialty (Author 4)
Internal Medicine
Academic Level (Author 5)
Resident
Discipline/Specialty (Author 5)
Internal Medicine
Discipline Track
Patient Care
Abstract
Introduction: Esophageal food impaction (EFI) is the third most common non-biliary emergency in gastroenterology with an annual incidence rate of 13 episodes per 100,000 person-years and 1,500 deaths per year. An underlying esophageal cause is commonly found, with structural abnormalities being the most common, and dysmotility disorders and malignancy less frequently. When a patient presents with EFI, removal of the food bolus within 24 hours is indicated, however more urgent removal if acute symptoms are present. The following is a patient that presented for acute food impaction at EG Junction.
Case presentation: A 64-year-old gentleman with past medical history of hepatitis C presented to the emergency department for intractable nausea and vomiting after eating chicken and mashed potatoes four days ago. He remained intolerant to solids and liquids, and he had a sensation of food stuck on his chest. He denied any chest pain, shortness of breath, drooling, odynophagia, abdominal pain or bloating, hematochezia, melena, hemoptysis, hematemesis. On physical examination, he has an obese body habitus, tenderness to palpation on the right upper quadrant and mild distention, no guarding, bowel sounds present. Initial management included supportive measures with IV fluids and Ondansetron as needed for nausea and vomiting. Laboratory workup showed leukocytosis with neutrophilia, and urine toxicology was positive for cocaine and opiates. CT abdomen showed no evidence of acute intra-abdominal or pelvis abnormality. Gastroenterology was consulted for further evaluation. Esophagogastroduodenoscopy was performed at 48 hours from admission. Food impaction at the level of the esophageal-gastric junction was found, with successful retrieval, as well as distal esophagitis. Mid-esophageal biopsy showed no eosinophils, ruling out eosinophilic esophagitis. Upon visual inspection of impacted food was noted as a hard/rubbery piece of chicken with no evidence of bone. Patient left against medical advice 2 hours after resolving food impaction.
Conclusion: EFI is a medical emergency and removal of impacted food should be performed in the initial 24 hours. Although our patient had removal out of this window, he did not have any complications. The esophagus is the most frequent site of obstruction in the gastrointestinal tract and typically meat, have been commonly associated.
Presentation Type
Poster
Recommended Citation
Bartl, Mery; Alexander, Blesset; Gomez Casanovas, Jose G.; Fleires, Alcibiades; and Mifuji, Roque, "A boneless chicken at EG Junction." (2024). Research Colloquium. 45.
https://scholarworks.utrgv.edu/colloquium/2023/posters/45
Included in
A boneless chicken at EG Junction.
Introduction: Esophageal food impaction (EFI) is the third most common non-biliary emergency in gastroenterology with an annual incidence rate of 13 episodes per 100,000 person-years and 1,500 deaths per year. An underlying esophageal cause is commonly found, with structural abnormalities being the most common, and dysmotility disorders and malignancy less frequently. When a patient presents with EFI, removal of the food bolus within 24 hours is indicated, however more urgent removal if acute symptoms are present. The following is a patient that presented for acute food impaction at EG Junction.
Case presentation: A 64-year-old gentleman with past medical history of hepatitis C presented to the emergency department for intractable nausea and vomiting after eating chicken and mashed potatoes four days ago. He remained intolerant to solids and liquids, and he had a sensation of food stuck on his chest. He denied any chest pain, shortness of breath, drooling, odynophagia, abdominal pain or bloating, hematochezia, melena, hemoptysis, hematemesis. On physical examination, he has an obese body habitus, tenderness to palpation on the right upper quadrant and mild distention, no guarding, bowel sounds present. Initial management included supportive measures with IV fluids and Ondansetron as needed for nausea and vomiting. Laboratory workup showed leukocytosis with neutrophilia, and urine toxicology was positive for cocaine and opiates. CT abdomen showed no evidence of acute intra-abdominal or pelvis abnormality. Gastroenterology was consulted for further evaluation. Esophagogastroduodenoscopy was performed at 48 hours from admission. Food impaction at the level of the esophageal-gastric junction was found, with successful retrieval, as well as distal esophagitis. Mid-esophageal biopsy showed no eosinophils, ruling out eosinophilic esophagitis. Upon visual inspection of impacted food was noted as a hard/rubbery piece of chicken with no evidence of bone. Patient left against medical advice 2 hours after resolving food impaction.
Conclusion: EFI is a medical emergency and removal of impacted food should be performed in the initial 24 hours. Although our patient had removal out of this window, he did not have any complications. The esophagus is the most frequent site of obstruction in the gastrointestinal tract and typically meat, have been commonly associated.