Endoscopic foreign body retrieval

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Endoscopic foreign body retrieval
Endoscopic still of gastric foreign body (toothbrush)
Specialtygastroenterology

Endoscopic foreign body retrieval refers to the removal of ingested objects from the

mental illness,[3] and prison inmates[4]
as these groups have a high rate of foreign body ingestion.

Commonly swallowed objects include

eyeglasses,[5] spoons,[6] and toothbrushes[5]
(see image).

Indications and contraindications

Some patients at risk for foreign body ingestion may not be able to give an accurate

shortness of breath if there is compression of the trachea.[1][7]

There are several situations in which endoscopic techniques are not indicated, such as for small blunt objects less than 2.5 cm which have already passed into the stomach (as these usually do not obstruct anywhere else), when there is

perforation of the esophagus or mediastinitis (inflammation of structures around the esophagus), and for narcotic-containing bags or condoms that have been ingested, because of the risk of overdose if they are ruptured.[1]

Foreign bodies should be removed from the esophagus within 24 hours of ingestion because of a high risk of complication.[8]

Non-invasive testing

Chest X-ray showing a Canadian dollar coin
in the esophagus of a young child

Prior to undertaking endoscopy, attempts should be made to locate the foreign body with

non-invasive techniques.[1] For radio-opaque objects, x-rays of the neck, chest and abdomen can be used to locate the foreign body and assist endoscopy.[9] Alternative approaches, including the use of metal detectors, have also been described.[10]

X-rays are also useful for identifying the type of foreign body ingested and complications of foreign body ingestion, including mediastinitis and perforation of the esophagus.[1]

Endoscopy

conscious sedation. Many techniques have been described to remove foreign bodies from the stomach and esophagus. Usually the esophagus is protected with an overtube (a plastic tube of varying length), through which the gastroscope and retrieved objects are passed.[11]

Once the foreign body has been identified with the gastroscope, various devices can be passed through the gastroscope to grasp or manipulate the foreign body. Devices used include

orogastric tubes.[12][15] Some techniques have been described that use foley catheters to trap objects, or use two snares to orient foreign bodies.[6]

Alternative methods

In veterinary medicine or when there is no endoscope available to extract foreign bodies economically without operation very often the Hartmann alligator forceps is used[citation needed]

See also

References

  1. ^
    PMID 12024131.{{cite journal}}: CS1 maint: numeric names: authors list (link
    )
  2. S2CID 21800189
    .
  3. PMID 7698623
    .
  4. S2CID 4232154
    .
  5. ^ a b Grover SC, Kim YI, Kortan PP, Marcon NE. Endoscopic removal of eight gastric foreign bodies ingested sequentially in twelve days: a case of creative endoscopy. Abstract presented at World Congress of Gastroenterology, Montreal, Canada, September 2005.
  6. ^
    PMID 12776067
    .
  7. S2CID 43510040
    .
  8. PMID 3985482
    .
  9. S2CID 27333104
    .
  10. PMID 16714508
    .
  11. S2CID 23798796
    .
  12. ^
    PMID 11132474
    .
  13. PMID 9476781
    .
  14. PMID 8903823
    .
  15. PMID 11201377
    .

External links
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