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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Esophageal foreign body/impaction (suspected) |
| ||
| Control (No symptoms of esophageal foreign body/impaction) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Point of care ultrasound | Diagnostic Test | Point of care medical ultrasound machines will be used to sonographically visualize the esophagus and following sonographic data will be collected:
|
| Measure | Description | Time Frame |
|---|---|---|
| Presence or absence of esophageal foreign body/food impaction | Presence of absence of esophageal foreign body/food impaction on esophagogastroduodenoscopy | Within 48 hours of index visit (Emergency department arrival to emergency department or hospital discharge) |
| Measure | Description | Time Frame |
|---|---|---|
| Number/proportion of subjects experiencing resolution of symptoms with standard medical therapies | Number/proportion of subjects experiencing resolution of symptoms with standard medical therapies, including glucagon and carbonated beverages | Within 48 hours of index visit (Emergency department arrival to emergency department or hospital discharge) |
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Eligibility (CASES)
Inclusion criteria:
Exclusion criteria:
Eligibility (CONTROLS)
Inclusion criteria:
Exclusion criteria:
Nausea/vomiting
Diarrhea
Abdominal pain
Chest pain
Shortness of breath
Dysphagia/odynophagia
Cough
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This will be a 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. We will also enroll an age/sex-matched control group of asymptomatic individuals to establish baseline esophageal measurements.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Kristen Oliff | Contact | 717-851-5075 | koliff@wellspan.org | |
| Brent Becker, MD | Contact | 717-851-4819 | bbecker2@wellspan.org |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| WellSpan Health York Hospital | Recruiting | York | Pennsylvania | 17403 | United States |
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| ID | Term |
|---|---|
| D000402 | Airway Obstruction |
| ID | Term |
|---|---|
| D012131 | Respiratory Insufficiency |
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
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| Number/proportion of subjects requiring endoscopic intervention | Number/proportion of subjects needing interventional procedures during esophagogastroduodenoscopy due to esophageal symptoms | Within 48 hours of index visit (Emergency department arrival to emergency department or hospital discharge) |