A retrospective cohort study on oesophageal food bolus obstruction in the North Denmark region in 2021-two thirds were never diagnosed with a cause

Jacob Holmen Terkelsen, Martin Hollænder, Kasper Bredal, Sara Munk Nielsen, Kristoffer Vittrup Koed Thomsen, Amanda Baggerman, Emilia Ofverlind, Alptug Mertcan Koc, Hannah Pakes, Marco Bassam Mahdi, Sanne Ørnfeldt Larsen, Vanessa Parra Gonzalez, Johannes Riis, Line Tegtmeier Frandsen, Dorte Melgaard, Anne Lund Krarup*

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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BACKGROUND: Food bolus obstruction (FBO) leading to hospital treatment is often associated with eosinophilic oesophagitis (EoE), stenosis, or oesophageal cancer (1). Danish national guidelines recommend that patients with FBO undergo a diagnostic upper endoscopy within two weeks of presentation to exclude possible malignancy, and histological evaluation of eight biopsies (2, 3).

AIMS: The aims of this study were to (1) report the incidence and describe the causes and treatment of FBO in the North Denmark Region (NDR), (2) determine the proportion of patients who underwent upper endoscopy and biopsy according to regional and national guidelines, and (3) identify International Classification of Diseases 10th Revision (ICD-10) diagnosis and procedure codes applied to the hospital visits due to FBO in the NDR.

METHODS: Among all acute hospital visits in the NDR in 2021, all visits with ICD-10 codes possibly reflecting FBO, as well as a random sample of 14,400 visits with unspecific ICD-10 codes (R and Z codes), were screened manually for possible FBO. Diagnosis, follow-up, and treatment of all patients with FBO were recorded.

RESULTS: The median patient age was 66.0 (Q1-Q3: 49.8-81.0) years, and half of the patients had experienced FBO before. Two thirds of patients (66.0%) were never diagnosed with a cause of FBO, followed by 17.3% with EoE. 30% of patients did not undergo upper endoscopy within two weeks of the hospital visit, and 50.7% were never biopsied in the oesophagus. Of 1886 hospital visits with registry ICD-10 codes that possibly reflected FBO, 8.4% were due to FBO, while FBO was present in 0.028% of the random sample of unspecific ICD-10 codes.

CONCLUSIONS: Most hospitalized FBO patients in the NDR in 2021 were never diagnosed with a cause. In these patients there is a high risk of overlooked EoE or upper gastrointestinal cancers. The area needs immediate focus and changed routines to improve treatment and prevent new FBO.

Original languageEnglish
Article number3
JournalBMC Gastroenterology
Issue number1
Publication statusPublished - 2 Jan 2024

Bibliographical note

© 2023. The Author(s).


  • Aged
  • Aged, 80 and over
  • Denmark/epidemiology
  • Eosinophilic Esophagitis/complications
  • Esophageal Stenosis/diagnosis
  • Humans
  • Middle Aged
  • Retrospective Studies
  • Oesophagus
  • Oesophageal cancer
  • Eosinophilic oesophagitis
  • Upper Endoscopy
  • Food Bolus obstruction
  • Food Bolus Impaction


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