Daniel J. Pallin, MD, MPH reviewing Bodkin RP et al. Am J Emerg Med 2016 Mar 8.

A retrospective study finds that resolution of impaction was no better with glucagon than without.

Glucagon causes relaxation of lower esophageal sphincter smooth muscle, and thus has become a widely used therapy for esophageal foreign body impaction. However, evidence in favor of this practice is spotty at best. These investigators reviewed charts for 127 children and adults with esophageal foreign body impaction who received glucagon, and 29 such patients who did not, at two academic emergency departments from 2006 to 2010. Patients with esophageal abnormalities were excluded.

Food was the cause of impaction in roughly 90% of cases. Most patients in the glucagon group (56%) received concomitant treatment with other medications (e.g., nitroglycerin, benzodiazepines). Resolution of impaction occurred in 14% of patients who received glucagon and 10% of those who did not (nonsignificant difference). Vomiting occurred in 13% of the glucagon patients.

Citation(s):

Bodkin RP et al. Effectiveness of glucagon in relieving esophageal foreign body impaction, a multi-center study. Am J Emerg Med 2016 Mar 8; [e-pub].

JWatch