Can a Nitro Slurry Fix a Food Bolus Impaction?

Can a Nitro Slurry Fix a Food Bolus Impaction?

Esophageal food impaction (EFI) occurs at an estimated rate of 13 episodes per 100,000 people annually. Medical management is typically attempted before resorting to endoscopy to reduce procedural risks and resource use. Glucagon remains the most widely used medication. Other treatments include carbonated beverages, benzodiazepines, and, more recently, nitroglycerin. Despite glucagon being the most commonly used agent, its supporting data are limited to small studies or case reports. One older study showing over 60% efficacy lacked a comparator group and had multiple confounders. Another study suggested only minimal benefit and significant adverse effects—up to 50% vomiting—highlighting the need for better treatment options.

Read More

Grand Rounds Recap 04.15.20

Grand Rounds Recap 04.15.20

We had another exemplary installment of Grand Rounds this week that started with Attending Case Followup with Drs. Lang, Baez, and Paulsen. Then we had some top-notch review of core curriculum with Dr. Winslow and the Alvarado Score for appendicitis, Drs. Meigh and Klaszky on food impactions and esophageal foreign bodies, and Drs. Comiskey and Nagle on D-dimer. Finally, Dr. Nagle gave us an overview of the foundations of evidence-based medicine with his R4 capstone.

Read More