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著者: Ganapathy A Prasad, Jagadeshwar G Reddy, Felicity T Boyd-Enders, Jeffrey A Schmoll, Jason T Lewis, Louis-Michel Wongkeesong
雑誌名: J Clin Gastroenterol. 2008 Aug;42(7):771-5. doi: 10.1097/MCG.0b013e31815576d2.
Abstract/Text
BACKGROUND: Esophageal food impaction (FI) is a distressing condition requiring urgent endoscopic intervention, with a reported recurrence rate between 10% and 20%. Knowledge of factors predisposing to recurrent FI may enable preventive measures to minimize the risk of recurrence.
OBJECTIVE: To identify risk factors associated with recurrent FI.
DESIGN: Retrospective case-control study.
SETTING: Tertiary referral center.
PATIENTS: A prospectively maintained database and medical records of all patients undergoing emergent endoscopy for FI from 1989 to 2000 were reviewed. Cases were defined as those presenting with more than 1 episode of FI, whereas controls were defined as those without recurrence within 5 years of the index episode. Several demographic, clinical, endoscopic, and follow-up variables were extracted. Statistical analysis included chi2 tests and t tests for univariate analysis, and stepwise logistic regression for multivariate analysis.
INTERVENTIONS: NA.
MAIN OUTCOME MEASUREMENTS: Predictors of recurrent FI.
RESULTS: A total of 52 cases and 124 controls were identified (recurrence rate 30%). Presence of a diaphragmatic hernia [odds ratio (OR) 2.65; confidence interval (CI) 1.19-5.89], disimpaction by piecemeal extraction (OR 2.32; CI 1.09-4.97), and acquisition of esophageal biopsies (OR 3.69; CI 1.42-9.66) increased odds for recurrent FI. Physician follow-up after FI decreased the odds for recurrent FI (OR 0.38; CI 0.18-0.80).
LIMITATIONS: Retrospective study.
CONCLUSIONS: The presence of a diaphragmatic hernia, complexity of endoscopic disimpaction technique, and lack of follow-up increased risk for recurrent FI. Collection of esophageal biopsies as a risk factor suggests a visibly more severe esophageal disorder as a potential cause for recurrent FI.
PMID 18580498 J Clin Gastroenterol. 2008 Aug;42(7):771-5. doi: 10.1097/MCG.0b013e31815576d2.
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