Hostname: page-component-5c6d5d7d68-wp2c8 Total loading time: 0 Render date: 2024-08-18T05:42:31.343Z Has data issue: false hasContentIssue false
  • English
  • Français

Myth: glucagon is an effective first-line therapy for esophageal foreign body impaction

Published online by Cambridge University Press:  21 May 2015

Sanjay Arora  and
Peter Galich
Sanjay Arora*
Affiliation:
Department of Emergency Medicine, Keck School of Medicine, University of Southern California, Los Angeles, Calif.
Peter Galich
Affiliation:
Department of Emergency Medicine, Keck School of Medicine, University of Southern California, Los Angeles, Calif.
*
Department of Emergency Medicine, LAC + USC Medical Center, 1200 N. State St. Rm. 1011, Los Angeles CA 90033; sanjayar@usc.edu

Extract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Esophageal foreign body impactions (EFBIs) are relatively rare in emergency medicine; patients rarely have them more than once. Indications for watchful waiting include a patent airway and the ability to clear secretions. However, in many cases, significant discomfort combined with patient expectations mandate early intervention to dislodge the foreign body. Endoscopy is the preferred definitive method of intervention for EFBI; however, most emergency physicians choose to apply one of several less invasive modes of therapy as firstline treatment. Pharmacologic agents that have been described for this purpose include glucagon, nifedipine, sublingual nitroglycerin, proteolytic enzymes and benzodiazepines. Among these, glucagon has become the most widely accepted in clinical practice.

Keywords

glucagonesophageal foreign bodyfood bolus
Type
Knowledge Applied to Practice Application des connaissances à la pratique
Information
Canadian Journal of Emergency Medicine , Volume 11 , Issue 2 , March 2009 , pp. 169 - 171
Copyright
Copyright © Canadian Association of Emergency Physicians 2009

References

1.Colon, V, Grade, A, Pulliam, G, et al. Effect of doses of glucagon used to treat food impaction on esophageal motor function of normal subjects. Dysphagia 1999;14:27–30.Google Scholar
2.Hogan, WJ, Dodds, WJ, Hoke, SE, et al. Effect of glucagon on esophageal motor function. Gastroenterology 1975;69:160–5.CrossRefGoogle ScholarPubMed
3.Ratcliff, KM. Esophageal foreign bodies. Am Fam Physician 1991;44:824–31.Google Scholar
4.Maglinte, DD, Chernish, SM, Kelvin, FM, et al. Pharmacoradiologic disimpaction of esophageal foreign bodies: review and recommendation. Emerg Radiol 1995;2:151–7.CrossRefGoogle Scholar
5.Lacy, PD, Donnelly, MJ, McGrath, JP, et al. Acute food bolus impaction: aetiology and management. J Laryngol Otol 1997;111:1158–61.CrossRefGoogle ScholarPubMed
6.Ferrucci, JT Jr, Long, JA Jr. Radiologic treatment of esophageal food impaction using intravenous glucagon. Radiology 1977;125:25–8.Google Scholar
7.Trenkner, SW, Maglinte, DDT, Lehman, GA, et al. Esophageal food impaction: treatment with glucagon. Radiology 1983;149:401–3.Google Scholar
8.Bryant, BG, Trout, DJ. Treatment of esophageal food impaction — a new use for glucagon. Drug Intell Clin Pharm 1982;16:407–9.Google Scholar
9.Reddy, AN. Noninvasive management of esophageal meat impaction. Gastrointest Endosc 1981;27:202–3.Google Scholar
10.Tibbling, L, Bjorkhoel, A, Jansson, E, et al. Effect of spasmolytic drugs on esophageal foreign bodies. Dysphagia 1995;10:126–7.Google Scholar
11.Mehta, DI, Attia, MW, Quintana, EC, et al. Glucagon use for esophageal coin dislodgement in children: a prospective, double-blind, placebo-controlled trial. Acad Emerg Med 2001;8:200–3.CrossRefGoogle ScholarPubMed
12.Sodeman, TC, Harewood, GC, Baron, TH. Assessment of the predictors of response to glucagon in the setting of acute esophageal food bolus impaction. Dysphagia 2004;19:18–21.CrossRefGoogle ScholarPubMed
13.Al-Haddad, M, Ward, EM, Scolapio, JS, et al. Glucagon for the relief of esophageal food impaction: Does it really work? Digestive Diseases and Sciences 2006;51:1930–3.CrossRefGoogle ScholarPubMed
14.Channer, KS, Bolton, R, al-Hilli, S, et al. The effect of glucagon on the swallowing of capsules. Br J Clin Pharmacol 1983;16:456–8.CrossRefGoogle ScholarPubMed
15.Anvari, M, Richards, D, Dent, J, et al. The effect of glucagon on esophageal peristalsis and clearance. Gastrointest Radiol 1989;14:100–2.Google Scholar
16.Fass, R, Dekel, R. Intravenous glucagon in food impaction — Use it or lose it? Dysphagia 2004;19:15–7.Google Scholar