Troy Rivera, PGY1

The Article: Bedside sonography for the diagnosis of esophageal food impaction. Singleton, J., Schafer, J. M., Hinson, J. S., Kane, E. M., Wright, S., & Hoffmann, B. (2017). The American journal of emergency medicine, 35(5), 720-724.

The Takeaway: This article looked at the utility of using bedside ultrasound for diagnosing esophageal food impaction. They performed a case-control series of 5 in each and analyzed them against each other. In each case, the views they obtained of the esophagus were as follows: High frequency linear probe transverse orientation over mid and lateral neck using the left thyroid lobe as a window to see the esophagus, high frequency probe in the left parasagittal orientation also looking through the left thyroid lobe, and the curvilinear probe in left parasagittal orientation to use the left liver lobe to see the GE junction. In all of the case series there were persistent air fluid levels visualized as well as a dilated esophagus compared to post food removal of the same views. 2 of the cases had direct visualization of the esophageal foreign body. The mean cervical esophageal diameter in the case group was 17.5 mm and the control group was 9.3 mm (p=0.0011). They argued that esophageal diameter and seeing air fluid levels can be a potential alternative to obtaining a CT neck before EGD to remove it (expediting care). Furthermore, since this was a small study, further studies confirming these findings would be needed.