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• W2912346877 abstract "Ingestion of sharp foreign body is an endoscopic emergency requiring quick intervention. Retrieval of sharp foreign bodies from the esophagus can be technically challenging and typically requires the use of a protective covering. Herein we report a case of double-edged razor removed from the esophagus with use of a modified overtube. A 51-year-old male patient presented with 4-hour history of chest pain after accidentally ingesting a double-edged razor blade. Chest x-ray showed a 4.5cm x 2.2cm razor blade in the lower esophagus. A latex hood was not available. Our team came up with a strategy to use an overtube (US Endoscopy) and a talon grasping device to retrieve the blade. We procured a similar blade with the same central opening and dimensions for ex-vivo testing. We ran tests of our proposed strategy with the devices before attempting to perform endoscopy. We tested a reported technique in which the curved part of the distal tip of the overtube was cut to flatten it in order to increase its width; however, it was not wide enough to accommodate the blade in our patient. We then cut the overtube with scissors along two sides for a length of 5 cm and removed the exposed wires from the tube to create a flexible hood. The hood's maximal width was 25mm. We then passed the regular endoscope without overtube. The razor blade was identified at 32cm from insertion. The scope was withdrawn and loaded with the overtube and reinserted. The end of the overtube was passed over the scope and placed just above the blade. We removed the blade by placing the end of the talon device into the hole at the center of the blade grabbing it and pulling it into the hood on its long axis. The overtube and scope were removed in tandem. A repeat CXR was unremarkable and the patient was discharged home. A variety ofmethods for removal of esophageal foreign bodies has been described in the literature. In an emergency situation when the ideal tools may not be always available, alternatives should be considered. This technique may be used with objects of varying sizes and dimensions and modified to required specifications. A modified overtube can accommodate objects up to 25 mm in width and varied lengths determined by the length of cuts made in the tube. In cases where the location of foreign body is beyond the reach of the esophageal overtube, we recommend using a longer gastric overtube with similar modification which can be advanced to the required distance.Figure: Split Overtube.Figure: Razor Blade within Overtube.Figure: Razor Blade after safe removal." @default.
• W2912346877 created "2019-02-21" @default.
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• W2912346877 date "2017-10-01" @default.
• W2912346877 modified "2023-09-26" @default.
• W2912346877 title "Safe Removal of Double-Edged Razor Blade With Modified Overtube" @default.
• W2912346877 doi "https://doi.org/10.14309/00000434-201710001-01824" @default.
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