P4937 - Factors Associated With Large Esophageal Bolus Impactions: A Single Center’s Experience

Neil Gambhir, DO, Sahil Patel, DO, Mark Arbuiso, DO, David H. Robbins, MD, MSc
Lenox Hill Hospital, Northwell Health, New York, NY

Introduction: Esophageal foreign body impactions (EFIs) represent an uncommon true gastrointestinal emergency. Though it is understood that patients afflicted with an EFI often require endoscopic retrieval, risk stratification is poorly understood. As such, the purpose of this study is to evaluate clinical factors associated with large bolus impactions to aid in the triage of this condition at our center

Methods: Retrospective chart review was conducted on patients who presented with an endoscopically confirmed EFI from 2015-2024 who were identified via ICD-10 codes. Subjects were placed into two cohorts, those with partial impactions (PI) and those with complete impactions (CI). Data abstracted included baseline demographics, comorbidities, endoscopic findings and substance impacted. Statistical analysis was conducted and P values < .05 were considered significant

Results: 139 patients were included in this study (PI=82, CI=58). There was no difference in cohort demographics though patients with complete impactions were more likely to have histories of hypothyroidism (14.0%CI vs 3.66% PI, p=0.026) and smoking (24.56%CI vs 9.76%PI, p=0.019). Overall, the most common type of bolus was that of red meat (47.48% 66/140). Regarding clinical presentation, patients with CIs were more likely to present with sialorrhea (62.07%CI vs 27.17%PI, p=< 0.001) and an inability to tolerate secretions (75.86%CI vs 35.37%PI, p=< 0.001). There were no statistically significant differences in endoscopically encountered pathology between cohorts though the incidence of eosinophilic esophagitis was more common in patients with CIs (24.18%).

Discussion: Patients who present with sialorrhea and an inability to tolerate secretions are more likely to have large bolus impactions. These patients should be considered high risk and require urgent gastroenterological intervention


Figure: Table 1: EGD findings

Disclosures:
Neil Gambhir indicated no relevant financial relationships.
Sahil Patel indicated no relevant financial relationships.
Mark Arbuiso indicated no relevant financial relationships.
David Robbins indicated no relevant financial relationships.

Neil Gambhir, DO, Sahil Patel, DO, Mark Arbuiso, DO, David H. Robbins, MD, MSc. P4937 - Factors Associated With Large Esophageal Bolus Impactions: A Single Center’s Experience, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.