Voedselimpactie: vaak flexibele, soms starre endoscopie

A rigid endoscope was used to remove impacted meat in the oesophagus of a 62-year-old male by means of rigid endoscopy. The procedure was complicated by a perforation of the distal oesophagus. This perforation was treated during a thoracolaparotomy by means of a surgical suture, fundoplication, gastrostomy and catheter jejunostomy. The patient ultimately died from septic complications. A 52-year-old woman also underwent rigid endoscopy because of food impaction in the oesophagus. This procedure was also complicated by oesophageal perforation, and by pneumothorax and mediastinitis. The patient was successfully treated with conservative measures. A 69-year-old man who presented with food impaction was successfully treated by pushing the food bolus into the stomach with a flexible endoscope. No complications arose. Food impactions often necessitate endoscopic treatment. Ascertaining the location and type of food impaction is important as this determines the choice of procedure. Rigid endoscopy is preferable for the impaction of sharp objects at the cricopharyngeal juncture, while food impactions below this point in the oesophagus should be treated using flexible endoscopy. In cases of doubt, flexible endoscopy is advised.