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Improvising in Endoscopy: Endoscopic Removal of Sharp Foreign Bodies in the Upper GI Tract, Using a Handmade Protective Device. Case Rep Gastrointest Med 2020; 2020:8881702. [PMID: 32963847 PMCID: PMC7499273 DOI: 10.1155/2020/8881702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/27/2020] [Accepted: 09/02/2020] [Indexed: 01/10/2023] Open
Abstract
Introduction. Foreign body ingestion is a common problem in large-volume endoscopic departments. Several techniques and devices have been described for the safe endoscopic removal of these objects. However, these devices may not be suitable in every clinical setting or—as in our case—they may not even be available. Case Presentation. We report the case of a 34-year-old patient, presenting with sharp foreign body ingestion. The foreign bodies were safely removed using a handmade protective hood due to lack of a commercial device. In our case, improvisation proved to be of great benefit for the patient as well as for the endoscopist. Discussion. Improvised interventions can be of special interest in the setting of insufficiently funded or equipped endoscopic departments.
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Gajbhiye AS, Gajbhiye RN, Tirupude BH, Bajaj PP, Gupta TH. Video endoscopy: removal of retained sewing needles from the duodenum. Indian J Surg 2014; 75:108-9. [PMID: 24426531 DOI: 10.1007/s12262-011-0360-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Accepted: 10/19/2011] [Indexed: 11/25/2022] Open
Abstract
We report an interesting case of a 21-year-old unmarried girl who swallowed six sewing needles. Her complaints were pain in the epigastrium, associated with nausea and vomiting. On examination, there was mild tenderness in the epigastrium. X-ray of the abdomen and endoscopy confirmed the presence of six needles in the duodenum, with tips lodged in the duodenal wall. Psychiatric opinion was sought which was normal. Under video endoscope (Pentax 2.8, EG 27708) guidance with Captura biopsy forceps without spikes (Cook DBF-2.4-160-S), six sewing needles were removed successfully from the duodenum through the endoscope channel without any complications. However, a video endoscopic removal of the retained six needles from duodenum is probably being reported for the first time.
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Affiliation(s)
- Ashok S Gajbhiye
- Department of General Surgery, Indira Gandhi Government Medical College, Central, Avenue road, Nagpur, Maharashtra India ; lot no. 54, kalpataru nagar, B/H Shahu nagar, Manewada, Nagpur, Mhalgi nagar, Post 440034 Maharashtra state India
| | - Raj N Gajbhiye
- Department of General Surgery, Indira Gandhi Government Medical College, Central, Avenue road, Nagpur, Maharashtra India ; lot no. 54, kalpataru nagar, B/H Shahu nagar, Manewada, Nagpur, Mhalgi nagar, Post 440034 Maharashtra state India
| | - Bhupesh H Tirupude
- Department of General Surgery, Indira Gandhi Government Medical College, Central, Avenue road, Nagpur, Maharashtra India ; lot no. 54, kalpataru nagar, B/H Shahu nagar, Manewada, Nagpur, Mhalgi nagar, Post 440034 Maharashtra state India
| | - Prasang P Bajaj
- Department of General Surgery, Indira Gandhi Government Medical College, Central, Avenue road, Nagpur, Maharashtra India ; lot no. 54, kalpataru nagar, B/H Shahu nagar, Manewada, Nagpur, Mhalgi nagar, Post 440034 Maharashtra state India
| | - Tarush H Gupta
- Department of General Surgery, Indira Gandhi Government Medical College, Central, Avenue road, Nagpur, Maharashtra India ; lot no. 54, kalpataru nagar, B/H Shahu nagar, Manewada, Nagpur, Mhalgi nagar, Post 440034 Maharashtra state India
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Alternative salvage technique for removing large sharp foreign body near upper esophageal sphincter. Surg Laparosc Endosc Percutan Tech 2012; 22:e48-52. [PMID: 22318080 DOI: 10.1097/sle.0b013e31824205a6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Removing sharp foreign bodies located in the esophagus can be dangerous and challenging. Proper apparatus and appropriate technique should be employed to avoid life-threatening complications such as perforation and mediastinitis. A 59-year-old man came to the emergency department with foreign body sensation in the upper esophagus which proved to be a large sharp fish bone impacted near upper esophageal sphincter. With the ordinary upper endoscope, the foreign body could not be retrieved even with the assistance of a cap. Foreign body removal was attempted again using a colonoscope with cap fitted at the end. Larger caliber of the scope rendered more stable support within the lumen enabling better maneuver of the scope tip to secure wider working space, and application of the cap permitted better visual field. Herein, we report the first case of successful removal of a large sharp fish bone impacted near the upper esophageal sphincter using cap assisted colonoscope.
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Tierney WM, Adler DG, Conway JD, Diehl DL, Farraye FA, Kantsevoy SV, Kaul V, Kethu SR, Kwon RS, Mamula P, Pedrosa MC, Rodriguez SA. Overtube use in gastrointestinal endoscopy. Gastrointest Endosc 2009; 70:828-34. [PMID: 19703691 DOI: 10.1016/j.gie.2009.06.014] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2009] [Accepted: 06/12/2009] [Indexed: 02/08/2023]
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Abstract
Gastrointestinal endoscopy is an evolving field kindled by technologic advances, scientific discoveries, and the innovative minds of endoscopists. The development and subsequent applications of overtubes in gastrointestinal endoscopy mirror this larger evolution. In this article, we review the development, applications, and complications associated with overtubes in gastrointestinal endoscopy.
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Affiliation(s)
- Christopher D Wells
- Division of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Arizona 85259, USA
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Madanick RD, Barkin JS. Endoscopically visualized suction catheter food disimpaction from a metallic esophageal stent. Gastrointest Endosc 2004; 60:321-3. [PMID: 15278076 DOI: 10.1016/s0016-5107(04)01556-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Ryan D Madanick
- Division of Gastroenterology, University of Miami School of Medicine, Mt. Sinai Medical Center, 4300 Alton Road, Miami Beach, FL 33140, USA
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Chang JJ, Yen CL. Endoscopic retrieval of multiple fragmented gastric bamboo chopsticks by using a flexible overtube. World J Gastroenterol 2004; 10:769-70. [PMID: 14991959 PMCID: PMC4716930 DOI: 10.3748/wjg.v10.i5.769] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
This is a rare case of a patient with mental disorder, who ingested nineteen pieces of fragmented bamboo chopsticks. We managed the multiple gastric foreign bodies with a sclerotherapy overtube, and these multiple fragmented bamboo chopsticks were retrieved successfully using the endoscopic method. There were only multiple erosions with hemorrhage over the mucosa of fundus and body of stomach, no fragments adhered or perforated through the gastric wall. The mucosa of esophagus was intact. The patient tolerated the procedure well and without any major complications. Multiple sharp elongated gastric foreign bodies can be successfully and safely retrieved by using protective sheath of oropharynx without assistance with laparoscopy or surgical intervention. This renders an option for the endoscopists to manage multiple elongated gastric foreign bodies.
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Affiliation(s)
- Jia-Jang Chang
- Department of Hepatogastroenterology, Chang Gung Memorial Hospital, Keelung, 222 Mai Chin Road, Keelung, Taiwan 204, China
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Kao LS, Nguyen T, Dominitz J, Teicher HL, Kearney DJ. Modification of a latex glove for the safe endoscopic removal of a sharp gastric foreign body. Gastrointest Endosc 2000; 52:127-9. [PMID: 10882983 DOI: 10.1067/mge.2000.106689] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- L S Kao
- Departments of Surgery and Gastroenterology, University of Washington School of Medicine, Seattle Division of the VA Puget Sound Health System, WA 98108, USA
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Abstract
The first use of an overtube to assist endoscopy was described more than 20 years ago. Since then a number of uses of overtubes have been described, but relatively few complications have been reported. We report a case of esophageal perforation caused by overtube insertion during endoscopic band ligation of varices. This case is unique in that the patient presented 13 days after the original procedure, and it is the first reported case of esophageal injury involving the modified Bard overtube. The existing literature involving overtube injury is also reviewed.
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Affiliation(s)
- J P Dinning
- Department of Internal Medicine, University of Arizona Health Sciences Center, Tucson 85724, USA
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Bertoni G, Sassatelli R, Conigliaro R, Bedogni G. A simple latex protector hood for safe endoscopic removal of sharp-pointed gastroesophageal foreign bodies. Gastrointest Endosc 1996; 44:458-61. [PMID: 8905368 DOI: 10.1016/s0016-5107(96)70099-8] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- G Bertoni
- Department of Digestive Endoscopy, S. Maria Nuova Hospital, Reggio Emilia, Italy
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Mamel JJ, Weiss D, Pouagare M, Nord HJ. Endoscopic suction removal of food boluses from the upper gastrointestinal tract using Stiegmann-Goff friction-fit adaptor: an improved method for removal of food impactions. Gastrointest Endosc 1995; 41:593-6. [PMID: 7672555 DOI: 10.1016/s0016-5107(95)70197-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- J J Mamel
- Division of Digestive Diseases and Nutrition, University of South Florida, College of Medicine, Tampa 33612, USA
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Bertoni G, Pacchione D, Conigliaro R, Sassatelli R, Pedrazzoli C, Bedogni G. Endoscopic protector hood for safe removal of sharp-pointed gastroesophageal foreign bodies. Surg Endosc 1992; 6:255-8. [PMID: 1465735 DOI: 10.1007/bf02498816] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Endoscopic removal of sharp and pointed foreign bodies in the upper gastrointestinal tract still poses technical difficulties. Overtubes may be uncomfortable to the patients and only objects fitting within a lumen of about 11-15 mm can be removed. We present here our preliminary experience with a commercially available new endoscopic end protector hood having the unique characteristic of maintaining its bell portion inverted during the progression of the scope through the gut and flipping back to its original shape during withdrawal through the lower esophageal sphincter. This prevents exposure of the esophageal and pharyngeal wall to injuries from the edges of the foreign body. We used this device to remove nine large sharp or pointed gastroesophageal foreign bodies in six consecutive patients in whom conventional techniques were considered unsafe or not technically feasible owing to the size and shape of the objects. In all cases, removal was successful and easily performed without bowel damage. We believe that this device enhances the safe removal of a wide variety of potentially dangerous gastroesophageal foreign bodies.
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Affiliation(s)
- G Bertoni
- Department of Digestive Endoscopy, S. Maria Nuova Hospital, Reggio Emilia, Italy
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Goldschmiedt M, Haber G, Kandel G, Kortan P, Marcon N. A safety maneuver for placing overtubes during endoscopic variceal ligation. Gastrointest Endosc 1992; 38:399-400. [PMID: 1607105 DOI: 10.1016/s0016-5107(92)70453-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Lee YK, Chae SI, Cho WS. Endoscopic extraction of a perforating wire from the stomach. Korean J Intern Med 1987; 2:285-7. [PMID: 3154842 PMCID: PMC4534943 DOI: 10.3904/kjim.1987.2.2.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
A Report on the succesful endoscopic removal of a wire 3.8 cm long which perforated the gastric wall.
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Gutierrez JG, Altman AR. A multipurpose overtube for diagnostic and therapeutic flexible fiberoptic endoscopy. Gastrointest Endosc 1986; 32:274-7. [PMID: 3743979 DOI: 10.1016/s0016-5107(86)71845-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A newly devised overtube for diagnostic and interventional endoscopy has been used in 140 cases. In 60 cases of acute gastrointestinal bleeding, adequate gastric lavage was completed in 14.1 +/- 1.3 min, using an average of 7.5 +/- 0.69 liters; the volume of fluid recovered was 103.9 +/- 0.58% of the volume infused. This tube also allows simultaneous gastric lavage and esophageal or gastric tamponade, enabling therapeutic intervention with sclerotherapy or bipolar coagulation in the patient with acute massive bleeding. This device can be employed for the removal of bezoars, foreign bodies, and multiple polyps.
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