The management of oesophageal soft food bolus obstruction: a systematic review

INTRODUCTIONOesophageal soft food bolus obstruction (OSFBO) is a surgical emergency. However, no national guidelines exist regarding its management. This paper systematically reviews the literature with respect to the management of OSFBO. METHODSRelevant studies included were identified from the the Cochrane Library, the National Center for Biotechnology Information and the US National Library of Medicine resources. A systematic review was performed on 8 November 2010. RESULTSThis systematic review of the management of OSFBO shows no evidence that any medical intervention is more effective than a ‘watch and wait’ policy in enabling spontaneous disimpaction. Furthermore, the use of hyoscine butylbromide for OSFBO probably stems from a misquoted textbook. Surgical removal of an OSFBO is effective but not without potential risk. There is some evidence to support surgical intervention within 24 hours to prevent complications deriving from the initial obstruction. CONCLUSIONSThere is a need for large double-bl...