Performing Esophageal Biopsies Is Safe During Upper Endoscopy for Food Impaction but Are Underperformed in Certain Populations.

Autor: Barlowe TS; Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, UNC-CH, Chapel Hill, NC, 27599-7080, USA., Redd WD; Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, UNC-CH, Chapel Hill, NC, 27599-7080, USA., Xue AZ; Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, UNC-CH, Chapel Hill, NC, 27599-7080, USA., Kiran A; Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, UNC-CH, Chapel Hill, NC, 27599-7080, USA., McCallen JD; Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, UNC-CH, Chapel Hill, NC, 27599-7080, USA., Eluri S; Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, UNC-CH, Chapel Hill, NC, 27599-7080, USA.; Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic Florida, Jacksonville, FL, USA., Reed CC; Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, UNC-CH, Chapel Hill, NC, 27599-7080, USA., Dellon ES; Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, UNC-CH, Chapel Hill, NC, 27599-7080, USA. edellon@med.unc.edu.; Division of Gastroenterology and Hepatology, Department of Medicine, Center for Gastrointestinal Biology and Disease, University of North Carolina School of Medicine, UNC-CH, CB#7080, Bioinformatics Building, 130 Mason Farm Rd., Chapel Hill, NC, 27599-7080, USA. edellon@med.unc.edu.
Jazyk: angličtina
Zdroj: Digestive diseases and sciences [Dig Dis Sci] 2024 Oct; Vol. 69 (10), pp. 3844-3852. Date of Electronic Publication: 2024 Aug 13.
DOI: 10.1007/s10620-024-08590-8
Abstrakt: Background: Despite recommendations to perform esophageal biopsies during esophagogastroduodenoscopy (EGD) for esophageal food impaction to evaluate for eosinophilic esophagitis (EoE), endoscopists often forgo biopsies. There are minimal data on the risks of biopsies in this setting.
Aims: To determine the safety of performing biopsies during EGD for food impaction.
Methods: We conducted a retrospective cohort study of patients who presented to University of North Carolina Hospitals from 2014 to 2021 with endoscopically confirmed food impaction. Data were abstracted from the medical records. Baseline clinical characteristics, procedural details, and adverse events were compared between patients who did and did not undergo biopsy. Adverse events were classified as esophageal (mucosal tear, bleeding, perforation) or extra-esophageal (aspiration, respiratory compromise, hypotension, arrhythmia).
Results: Of 188 patients who underwent EGD for food impaction, 73 (39%) had biopsies taken. Older and non-White patients were less likely to be biopsied. None of the Black patients had biopsies taken. Only 2 (2.7%) of the 73 biopsied patients had an adverse event, and neither was related to the biopsies. Patients who were biopsied were less likely to experience adverse events. There were no differences in re-admission, ICU admission, or 30-day mortality between patients who were and were not biopsied.
Conclusions: Esophageal biopsies remain underperformed during EGD for food impaction, especially in certain patient populations. Esophageal biopsies at the time of food impaction are unlikely to cause adverse events. Safety concerns should not preclude biopsies, and biopsies should be performed in the absence of extenuating circumstances.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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