An innovative fast track solution for food bolus impaction due to Jackhammer esophagus in an emergency department: the “Nitro-Push Blind Technique” case report

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Background:
In the medical literature are described only few clinical cases of esophageal food bolus impaction due to esophageal motility disorders. Moreover, the management of this condition is highly variable with no evidence in the literature to strongly support a clear defined intervention.

Case presentation:
In this paper we describe for the first time a case of 53-year-old male with food bolus impaction due to Jackhammer esophagus referred to emergency department. On the basis of the known esophageal past medical history as well as the absence of bones in the bolus, the patient was submitted to a new conservative treatment, the “Nitro-Push Blind Technique”.

Conclusions:
The new technique performed with naso-gastric tube thrust after nitrates medication in definite clinical case supported by known functional disease, represents a safe and successful method, with short observational period to minimize exposure to potential morbidity and reduce the inpatient stay in emergency department. It should be recommended, once validated in a larger cohort, as the initial treatment of choice in the selected patients with food boneless bolus impaction in the emergency settings. Indeed, this management provides only minimal deviation from the current practice and is hence technically easy to learn and perform.

Keywords:
Esophageal food bolus impaction, Jackhammer esophagus, Nutcracker esophagus, Case report

Autoři: Luigi Marano ^1,2*; Alessandro Cecchi ²; Federica Chiodo ²; Francesco Gullo ²; Pasquale Fiorillo ²; Luca Roncetti ²; Mattia Longaroni ²; Gianluca Proietti Silvestri ²; Silvano Lolli ²; Giorgio Nicolic ²; Alberto Patriti ¹
Působiště autorů: Unit of Robotic Surgery, “San Matteo degli Infermi Hospital” – ASL Umbria , 06049 Spoleto (PG), Italy ¹; Department of Emergency Medicine and Surgery, “San Matteo degli Infermi Hospital” – ASL Umbria 2, Via Loreto 3, 06049 Spoleto (PG), Italy ²
Vyšlo v časopise: BMC Gastroenterology 2016, 16:95
Kategorie: Case report
prolekare.web.journal.doi_sk: https://doi.org/10.1186/s12876-016-0511-7

© 2016 The Author(s).

Open access
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
The electronic version of this article is the complete one and can be found online at: http://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-016-0511-7

Souhrn

Keywords:
Esophageal food bolus impaction, Jackhammer esophagus, Nutcracker esophagus, Case report

Zdroje

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