S1060 Factors Associated With Large Esophageal Bolus Impactions: A Single Center’s Experience

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 International Classification of Diseases-10 codes. Subjects were placed into 2 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: One hundred thirty-nine 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%). Conclusion: 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.