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• W3094576298 abstract "INTRODUCTION: Foreign body (FB) ingestion is common in the United States with an incidence of 120 per 1 million people, and accounts for 1500 fatalities annually. Endoscopic intervention is the preferred modality for FB removal with success rates between 83% and 99%. Endoscopic tools used in FB removal include snares, retrieval nets, grasping forceps and overtubes. Use of endoscopic scissors is rare, yet can prove valuable in specific cases. CASE DESCRIPTION/METHODS: A 58-year-old female with severe cognitive deficiency presented for dark red stool in her colostomy bag. She had a history of multiple FB ingestions requiring both endoscopic and surgical removal. On presentation vitals were unremarkable and physical examination revealed a soft, nontender abdomen. CTA of the abdomen showed no active hemorrhage, but did show metallic foci in the stomach, presumably ingested material. Labs were significant for a hemoglobin 10.6 g/dL. The patient underwent endoscopy which revealed a large (5 × 3 cm) FB of unclear material in the gastric body. Removal was attempted with a snare but was unsuccessful as the FB was too large to pass through the gastroesophageal junction. Repeat endoscopy was performed. An overtube was passed beyond the gastroesophageal junction and FB removal was again attempted with a snare. Retrieval was initially unsuccessful as the FB became lodged in the end of the overtube causing a fracture to the distal end of the overtube. The overtube was then removed and endoscopic scissors were used to transect the FB. Complete removal was then accomplished with a retrieval net and snare. The post procedural course was uncomplicated. DISCUSSION: Endoscopic retrieval of a FB is an efficacious procedure. In a retrospective study, 97.92% of 144 endoscopic FB removal procedures were successfully performed. Three cases were unsuccessful with one requiring surgical intervention. Endoscopic scissors were not used in any of the cases. There has been only one previous case reporting the use of endoscopic scissors for FB removal- to transect a chicken bone in one patient’s proximal esophagus. The successful use of endoscopic scissors in this case allowed our patient to avoid the need for surgical FB removal. This is the first reported case of the use of endoscopic scissors to assist in FB removal from the stomach. This case highlights a novel approach to gastric FB removal which should be considered in select cases to further improve the efficacy of endoscopic FB removal and reduce the need for surgical intervention.Figure 1.: Large foreign body in the gastric body.Figure 2.: Foreign body unable to pass the gastroesophageal junction.Figure 3.: Endoscopic scissors being used to transect the foreign body." @default.
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• W3094576298 date "2020-10-01" @default.
• W3094576298 modified "2023-09-25" @default.
• W3094576298 title "S2339 Novel Approach to Endoscopic Foreign Body Retrieval From the Gastric Body" @default.
• W3094576298 doi "https://doi.org/10.14309/01.ajg.0000711404.71084.5f" @default.
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