955 An Audit for Reviewing the Soft Food Bolus Obstruction - Optimum Intervention and Referral Direction

Abstract

Abstract Introduction Absolute dysphagia secondary to impacted soft food bolus in oesophagus can occur due to various reasons. Existing pathway was ENT if patient points above the suprasternal notch and GI if below or at the level of notch. Objectives To assess management in patients with soft food bolus dysphagia and reviewing old pathway. Method Data was collected via clinical governance, case notes on track and analysed overall pathway of patients and discussed with the consultants; Paid attention to patients requiring surgical interventions, compared the complications 0f OGD and rigidscopy. Also, effectiveness of Buscopan weighing its adverse effects. Results Total of 147 cases were included, 2 patients from upper GI being secondarily referred to ENT, 18 of ENT with GI, 3.8 of 19% complications has risk of perforations with Rigid scope. 2.6% had risk with OGD with no perforations. 2% needed OGD after rigid. 85% underwent intervention after Buscopan. Conclusions There is no compelling evidence for Buscopan - to be used only for patient satisfaction. Combining Multiple transfers & complex patient journeys causing delay for treatments with less complications of OGD, soft food bolus should be managed by local gastro/gen surgery teams who can provide timely appropriate intervention, ENT involvement only if airway or pharyngeal concern.