Esophageal Foreign Body, Esophageal Obstruction
Conditions
Brief summary
This will be a prospective, observational, case-control study of adult patients presenting to the WellSpan York Hospital Emergency Department (YHED) with signs and symptoms of esophageal food or foreign body impaction. Point of care ultrasound (POCUS) will then be performed by a trained emergency physician to collect ultrasound data, including the presence or absence of direct visualization food bolus/foreign body, as well as secondary markers of dilatation, such as maximal esophageal area. Investigators will also enroll an age/sex-matched control group of asymptomatic individuals to establish baseline esophageal measurements. Patients will otherwise receive medical treatment per standard of care. Subsequent interventions will also be documented, including glucagon, carbonated beverages, and esophagogastroduodenoscopy (EGD). If patients remain in the ED and improve without need for EGD they will undergo repeat ultrasound. Chart review at 1 month will be performed to establish results of EGD including improvement, recurrence, or presence of pathologic abnormalities. The investigators aim to establish normal and abnormal parameters to aid in the diagnosis of esophageal food impactions to predict need for definitive EGD management.
Interventions
DIAGNOSTIC_TESTPoint of care ultrasound
Point of care medical ultrasound machines will be used to sonographically visualize the esophagus and following sonographic data will be collected: * Presence/absence of suspected foreign body * Sonographic esophageal measurements (diameters, area) * Other relevant secondary sonographic findings
Sponsors
WellSpan Health
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Eligibility (CASES) * Inclusion criteria: 1. Age ≥18 years 2. Signs and symptoms of esophageal food bolus or foreign body *
Exclusion criteria
1. Prior esophageal surgery 2. History of head/neck cancer 3. Incarcerated individuals 4. Individuals unable to provide consent 5. Clinical instability or airway compromise Eligibility (CONTROLS) * Inclusion criteria: 1. Age ≥18 years 2. NO signs or symptoms of esophageal food bolus or foreign body 3. Age/Sex match to previously enrolled case subject *
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Presence or absence of esophageal foreign body/food impaction | Within 48 hours of index visit (Emergency department arrival to emergency department or hospital discharge) | Presence of absence of esophageal foreign body/food impaction on esophagogastroduodenoscopy |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number/proportion of subjects experiencing resolution of symptoms with standard medical therapies | Within 48 hours of index visit (Emergency department arrival to emergency department or hospital discharge) | Number/proportion of subjects experiencing resolution of symptoms with standard medical therapies, including glucagon and carbonated beverages |
| Number/proportion of subjects requiring endoscopic intervention | Within 48 hours of index visit (Emergency department arrival to emergency department or hospital discharge) | Number/proportion of subjects needing interventional procedures during esophagogastroduodenoscopy due to esophageal symptoms |
Countries
United States
Contacts
CONTACTKristen Oliff
CONTACTBrent Becker, MD
Outcome results
None listed