| Cavo JW Jr et al, 1977, US | 90 patients with oesophageal meat impaction: 44 patients received caroid solution (papain) 37 patients received papain 8 patients received various enzymes 1 patient received Adolph’s meat tenderiser (papain) | Case review | Passage of the impacted meat Complications | Bolus successfully passed in 89 cases Bolus not passed in 1 case 2 patients died (oesophageal perforation, mediastinitis, and great vessel perforation) | Most cases given barium before enzymes. Dose of enzyme given varied between studies Some studies retrospective. Not all studies treated consecutive patients. One of the patients who died from perforation had meat impaction for 10 days before presentation. |
| Hall ML and Huseby JS, 1988, USA | 1 patient with oesophageal meat impaction Adolph’s meat tenderiser (papain) | Case report | Passage of the impacted meat Complications | Meat bolus not passed Haemorrhagic pulmonary oedema | Given barium before enzymes Given meperidine, glucagon and diazepam after enzyme, then intubated |
| Maini S et al, 2001, UK | 1 patient with oesophageal meat impaction | Case report | Passage of the impacted meat | Successfully passed | |
| Papain | | Complications | Aspiration pneumonitis | |