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Meta-Analysis
. 2011 Sep;93(6):441-4.
doi: 10.1308/003588411X588090.

The management of oesophageal soft food bolus obstruction: a systematic review

D Leopard  1 , S Fishpool, S Winter
Affiliations
Meta-Analysis

The management of oesophageal soft food bolus obstruction: a systematic review

D Leopard et al. Ann R Coll Surg Engl. 2011 Sep.

Abstract

Introduction: Oesophageal soft food bolus obstruction (OSFBO) is a surgical emergency. However, no national guidelines exist regarding its management. This paper systematically reviews the literature with respect to the management of OSFBO.

Methods: Relevant studies included were identified from the the Cochrane Library, the National Center for Biotechnology Information and the US National Library of Medicine resources. A systematic review was performed on 8 November 2010.

Results: This systematic review of the management of OSFBO shows no evidence that any medical intervention is more effective than a 'watch and wait' policy in enabling spontaneous disimpaction. Furthermore, the use of hyoscine butylbromide for OSFBO probably stems from a misquoted textbook. Surgical removal of an OSFBO is effective but not without potential risk. There is some evidence to support surgical intervention within 24 hours to prevent complications deriving from the initial obstruction.

Conclusions: There is a need for large double-blind, randomised, placebo controlled trials of drugs used in the medical management of OSFBO. Until the results from such trials are available, the treatment of OSFBO will remain based on inconsistent clinical judgement.

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Figures

Figure 1
Figure 1
Initial medications prescribed for cases of oesophageal soft food bolus obstruction (by A&E, ENT or General Surgery)
Figure 2
Figure 2
Medical management given to those patients in whom the food bolus passed without surgical intervention
Figure 3
Figure 3
Medical management given to those patients in whom the food bolus required surgical removal
See this image and copyright information in PMC

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MeSH terms