Abstract
Purpose
Glucagon is thought to decrease lower esophageal sphincter tone and is used as an
alternative to invasive endoscopy for esophageal foreign body impaction (EFBI). The
purpose of this study was to evaluate efficacy and safety of glucagon and identify
characteristics associated with success.
Methods
A multicenter, retrospective study of patients receiving glucagon for EFBI at 2 academic
emergency departments was conducted between 2006 and 2010. A control group of patients
that did not receive glucagon was evaluated. Data collection included demographics,
type of foreign body, glucagon dose, resolution of impaction, incidence of vomiting,
additional medication, and endoscopy required. Descriptive and univariate analysis
was performed as appropriate.
Results
A total of 133 doses of glucagon were administered in 127 patients. Glucagon-related
resolution of EFBI occurred in 18 patients (14.2%) and vomiting in 16 patients (12.6%).
No statistical differences between successful and unsuccessful groups were seen with
the exception of concomitant medication administration (benzodiazepine or nitroglycerin)
being associated with less glucagon success, 33.3% vs 59.6%, respectively (P = .04). Eighty-four percent of patients in the unsuccessful group underwent endoscopy.
Comparing those that received glucagon (n = 127) and the control group (n = 29), there
was no significant difference in resolution of EFBI, 14.2% vs 10.3%, respectively
(P = .586).
Conclusions
Glucagon-related resolution occurred in 14.2% of patients and was not significantly
different compared with those that did not receive glucagon (10.3%). Concomitant medication
administration was associated with lower success. Overall, glucagon had a low success
rate, was related to adverse effects, and does not offer advantages for treatment.
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Article Info
Publication History
Published online: March 08, 2016
Accepted:
March 5,
2016
Received in revised form:
March 4,
2016
Received:
January 19,
2016
Footnotes
☆Source of support: none.
☆☆Prior presentations: none.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
