Point of Care Ultrasound for the Detection of Esophageal Food Bolus

Point of Care Ultrasound for the Detection of Esophageal Food Bolus

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.

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

• Exclusion criteria:

  1. Prior esophageal surgery/dilation/pathology
  2. History of head/neck cancer
  3. Incarcerated individuals
  4. Individuals unable to provide consent
  5. Clinical instability or airway compromise
  6. Presentation involving any of the following symptoms:

• Nausea/vomiting

• Diarrhea

• Abdominal pain

• Chest pain

• Shortness of breath

• Dysphagia/odynophagia

• Cough