BACKGROUND AND AIMS Food impactions are a common reason for emergent upper endoscopy. Current guidelines call for urgent upper endoscopy (within 24 hours) for food impactions without complete esophageal obstruction and emergent endoscopy (within 6 hours) for those with complete esophageal obstruction. Multiple adverse events can arise from esophageal foreign bodies. Cases with longer delays from symptom onset to presentation have been associated with higher rates of surgical intervention. However, data on esophageal soft food impactions are scant. We set out to determine differences in outcomes for food impactions undergoing intervention within 12 hours versus over 12 hours of symptom onset. METHODS A retrospective review of medical records was conducted to identify patients who presented to our hospital with an esophageal soft food impaction and underwent an EGD between January 2010 and January 2018. Patients were divided into 2 groups based on the timing from symptom onset to EGD. An EGD within 12 hours was considered an early intervention and over 12 hours was considered a delayed intervention. Patients who had ingested bones or hard objects were not included. Primary outcomes studied were rates of aspiration, admission, local esophageal adverse events, and 30-day all-cause mortality. RESULTS We identified 110 patients with a soft food impaction who underwent an EGD. Forty- two patients had an early intervention and 68 a delayed intervention. There were no differences in basic demographics and comorbidities. Additionally, there were no differences in rates of local esophageal adverse events, aspiration, admission, or 30-day mortality. Multivariate analysis revealed endoscopic accessory use was associated with increased odds of local esophageal adverse events (odds ratio, 6.37; P = .01). CONCLUSIONS The overall rates of serious adverse events in esophageal soft food impactions are low. Delayed intervention is not associated with increased adverse events or 30-day mortality compared with early intervention. However, accessory use is associated with higher adverse event rates.

中文翻译：

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食管软性食管嵌顿延迟内镜治疗的结果。

背景和目的食物影响是出现上内镜的常见原因。目前的指南要求对没有完全食管阻塞的食物撞击进行紧急上内镜检查（24小时内），对于完全食道阻塞的食物要求紧急内镜检查（6小时内）。食道异物可引起多种不良事件。从症状发作到表现延迟时间较长的病例与较高的外科手术干预率有关。但是，有关食道软性食物受影响的数据很少。我们着手确定在12小时内与12小时以上症状发作之间进行干预的食物影响的结果差异。方法回顾性分析病历，以确认在2010年1月至2018年1月期间到我院接受食管软性食物冲击并接受了EGD的患者。根据从症状发作到EGD的时间将患者分为两组。在12小时之内的EGD被认为是早期干预，而在12小时以上的EGD被认为是延迟干预。不包括摄入骨骼或坚硬物体的患者。研究的主要结局是吸入率，入院率，局部食道不良事件和30天全因死亡率。结果我们确定了110名患有软性食物感染的患者接受了EGD。42例患者进行了早期干预，68例患者进行了延迟干预。基本人口统计学和合并症没有差异。此外，局部食管不良事件，误吸，入院或30天死亡率的发生率无差异。多变量分析显示，内镜辅助附件使用与局部食管不良事件发生几率增加相关（赔率比为6.37； P = 0.01）。结论食管软性食物受累的严重不良事件的总体发生率较低。与早期干预相比，延迟干预与不良事件增加或30天死亡率无关。但是，附件的使用与较高的不良事件发生率相关。结论食管软性食物受累的严重不良事件的总体发生率较低。与早期干预相比，延迟干预与不良事件增加或30天死亡率无关。但是，附件的使用与较高的不良事件发生率相关。结论食管软性食物受累的严重不良事件的总体发生率较低。与早期干预相比，延迟干预与不良事件增加或30天死亡率无关。但是，附件的使用与较高的不良事件发生率相关。