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To the Editor:—
In the article "Impaction of Food Bolus in the Esophagus" in The Journal, April 23, page 1922, reference is made to the use of digestant agents for the treatment of food boli impacted in the esophagus. I would like to point out that the use of such agents in patients with impaction in the esophagus must be approached with caution. Andersen and co-workers (Ann. Otol. Rhin. & Laryng.68:890 (Sept.) 1959) reported an instance of fatal perforation of the esophagus which occurred in a 27-year-old woman after the use of a digestive solution (Caroid) for meat impaction in the esophagus.After experimental investigations prompted by this incident, Andersen postulated that stretching and compression of the esophageal wall, resulting from impaction, caused sufficient ischemia for the proteolytic enzyme (papain) in the digestant to act. In this connection it is of interest to refer to studies by Derrick
Trimble GX. IMPACTION IN THE ESOPHAGUS. JAMA. 1960;173(8):932. doi:https://doi.org/10.1001/jama.1960.03020260072020
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