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Syamal MN. Adult Esophageal Foreign Bodies. Otolaryngol Clin North Am 2024; 57:609-621. [PMID: 38350826 DOI: 10.1016/j.otc.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
This manuscript reviews and outlines the necessary tools to efficiently assess and manage an adult patient where an esophageal foreign body is suspected. It reviews the vulnerable populations and relevant diagnostics and provides a triage diagram to aid in timely intervention. Management with esophagoscopy is reviewed as well as potential complications that may arise. Lastly, to illustrate the concepts of this section, a case study is presented to highlight the salient points.
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Affiliation(s)
- Mausumi Natalie Syamal
- Laryngology, Department of Otorhinolaryngology, Division of Laryngology, Rush University Medical Center, 1611 West Harrison Street, Suite 550, Chicago, IL 60612, USA.
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Fung BM, Sweetser S, Wong Kee Song LM, Tabibian JH. Foreign object ingestion and esophageal food impaction: An update and review on endoscopic management. World J Gastrointest Endosc 2019; 11:174-192. [PMID: 30918584 PMCID: PMC6425280 DOI: 10.4253/wjge.v11.i3.174] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 03/08/2019] [Accepted: 03/11/2019] [Indexed: 02/06/2023] Open
Abstract
Foreign body ingestion encompasses both foreign object ingestion (FOI) and esophageal food impaction (EFI) and represents a common and clinically significant scenario among patients of all ages. The immediate risk to the patient ranges from negligible to life-threatening, depending on the ingested substance, its location, patient fitness, and time to appropriate therapy. This article reviews the FOI and EFI literature and highlights important considerations and implications for pediatric and adult patients as well as their providers. Where published literature is insufficient to provide evidence-based guidance, expert opinion is included to supplement the content of this comprehensive review.
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Affiliation(s)
- Brian M Fung
- UCLA-Olive View Internal Medicine Residency Program, Sylmar, CA 91342, United States
| | - Seth Sweetser
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, United States
| | - Louis M Wong Kee Song
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, United States
| | - James H Tabibian
- Division of Gastroenterology, Olive View-UCLA Medical Center, Sylmar, CA 91342, United States
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Cao L, Chen N, Chen Y, Zhang M, Guo Q, Chen Q, Cheng B. Foreign body embedded in the lower esophageal wall located by endoscopic ultrasonography: A case report. Medicine (Baltimore) 2018; 97:e11275. [PMID: 29953004 PMCID: PMC6039637 DOI: 10.1097/md.0000000000011275] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
RATIONALE Ingested esophageal foreign bodies are commonly seen in adult population. In very few instances, esophageal foreign body may pass through the mucosal surface, re-epithelialize or migrate into surrounding soft tissues. PATIENT CONCERNS A 55-year-old Chinese male was admitted to our hospital with a 10-day history chest and upper abdominal pain without dysphasia, cough or other symptoms. DIAGNOSES We initially suspected chronic gastritis, and thoracic computed tomography and endoscopy ultrasonography (EUS) were used to identify a fish bone completely embedded within the lower esophageal wall. INTERVENTIONS Under the EUS-guidance, we marked the foreign body using methylene blue with saline solution, which was followed by successful thoracoscopy and surgical removed of the foreign body. OUTCOMES The patient recovered well and was discharged 1 week postoperatively. One month postoperatively, the patient was symptom free and the chest wound was complete healed. LESSONS Our case showed that computed tomography is necessary to diagnose the esophageal foreign body, and EUS may help confirm the position of foreign body, especially those embedded in the esophageal submucosa. We advocate necessary surgery at the first accurate diagnosis in patient with esophageal foreign body when endoscopy is not possible.
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Boo SJ, Kim HU. Esophageal Foreign Body: Treatment and Complications. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2018; 72:1-5. [DOI: 10.4166/kjg.2018.72.1.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Sun-Jin Boo
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Heung Up Kim
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
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Endoscopic Management of Foreign Bodies in the Gastrointestinal Tract: A Review of the Literature. Gastroenterol Res Pract 2016; 2016:8520767. [PMID: 27807447 PMCID: PMC5078654 DOI: 10.1155/2016/8520767] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 08/04/2016] [Indexed: 01/01/2023] Open
Abstract
Foreign body ingestion is a common diagnosis that presents in emergency departments throughout the world. Distinct foreign bodies predispose to particular locations of impaction in the gastrointestinal tract, commonly meat boluses in the esophagus above a preexisting esophageal stricture or ring in adults and coins in children. Several other groups are at high risk of foreign body impaction, mentally handicapped individuals or those with psychiatric illness, abusers of drugs or alcohol, and the geriatric population. Patients with foreign body ingestion typically present with odynophagia, dysphagia, sensation of having an object stuck, chest pain, and nausea/vomiting. The majority of foreign bodies pass through the digestive system spontaneously without causing any harm, symptoms, or necessitating any further intervention. A well-documented clinical history and thorough physical exam is critical in making the diagnosis, if additional modalities are needed, a CT scan and diagnostic endoscopy are generally the preferred modalities. Various tools can be used to remove foreign bodies, and endoscopic treatment is safe and effective if performed by a skilled endoscopist.
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Abstract
A 57-year-old man presented to the hospital because of swallowing of a small marble precipitated by a hallucination. He subsequently developed chest discomfort. He had a history of psychiatric problem and an esophageal corrosive injury complicated by stricture of the middle esophagus.This report describes the novel idea of endoscopic intervention for the retrieval of an esophageal foreign body. Its inventiveness and the use of limited resources, by adapting a 30-mm aseptic common tubing into an endoscopic retrieving device, make the method novel. This novel low-cost endoscopic cap (NLCEC) was adapted to 25 mm of the front end of the endoscope, with 5 mm maintained for the soft part to prevent esophageal mucosal injury during the retrieval process. An 8-mm green marble was found impacted in the esophagus 32 cm from the incisors. The use of forced suction allowed for the successful retrieval of the marble within minutes. The patient had an uneventful recovery without any serious complications.This NLCEC may be a viable and safe tool for the endoscopic retrieval of esophageal foreign objects without general anesthesia. This innovative design is beneficial in terms of patient safety, easy preparation, and low cost.
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Affiliation(s)
- King-Wah Chiu
- From the Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital (K-WC, L-SL, T-CW, S-SC); and College of Medicine, Chang Gung University, Taiwan, Republic of China (K-WC)
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Hernot S, Yadav SPS, Kathuria B, Kaintura M. An uncommon oesophageal foreign body in a neonate. BMJ Case Rep 2015; 2015:bcr-2014-208719. [PMID: 25636634 DOI: 10.1136/bcr-2014-208719] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
We report a case of a 2-month-old male child who presented with sudden onset of vomiting and refusal to breast feed. Chest and abdomen examination were normal. A foreign body (zipper) was visualised in the cervical oesophagus on X-ray of the neck. The retrieval of the zipper by oesophagoscopy relieved the symptoms of the patient.
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Affiliation(s)
- Sharad Hernot
- Department of ENT, Pandit Bhagwat Dayal PGIMS, Rohtak Haryana, India
| | | | - Bhushan Kathuria
- Department of ENT, Pandit Bhagwat Dayal PGIMS, Rohtak Haryana, India
| | - Madhuri Kaintura
- Department of ENT, Pandit Bhagwat Dayal PGIMS, Rohtak Haryana, India
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Removal and management of esophageal foreign bodies. TECHNIQUES IN GASTROINTESTINAL ENDOSCOPY 2014. [DOI: 10.1016/j.tgie.2013.10.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Nassar E, Yacoub R, Raad D, Hallman J, Novak J. Foreign Body Endoscopy Experience of a University Based Hospital. Gastroenterology Res 2013; 6:4-9. [PMID: 27785219 PMCID: PMC5051113 DOI: 10.4021/gr517w] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/25/2013] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Guidelines support endoscopic removal of certain gastric FB and all FB lodged in the esophagus. We aim to report our experience on endoscopic foreign bodies (FB) removal in order to aid in the formation of future guidelines regarding this subject. METHODS Retrospective analysis of one hundred forty-four cases of FB removal involving 43 patients who underwent esophagogastroduodenoscopy (EGD) for FB removal from January 2005 through December 2010 in a university-based hospital. To evaluate to outcome of endoscopic FB removal, cost of procedures and complications. RESULTS Of all FB removal cases, 23 (53%) were males, with total mean age of 26.4 ± 11.3 years. Only 20% were performed on an outpatient bases. Abdominal x-ray was obtained to confirm ingestion of FB in 83%, and computed tomography scan was performed in 13%. Most procedures were performed in operation room (59%) while only 21% of the cases were performed in endoscopy lab. General anesthesia was used in 58%, while monitored anesthesia care in 28%. Average time to EGD was 17.14 hours. No major complications due to procedure were reported. Minor trauma and erosions due to FB were reported in 14%. FB extraction was unsuccessful in only three cases, and one case required surgical intervention. Cost of all procedures was over 430, 000 dollars with mean of 2,990 dollars for procedure. CONCLUSION Endoscopic retrieval is effective and safe procedure, but utilizes significant hospital resources.
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Affiliation(s)
- Eiad Nassar
- Department of Gastroenterology, State University of New York at Buffalo, NY, USA
| | - Rabi Yacoub
- Department of Medicine, State University of New York at Buffalo, NY, USA
| | - Dany Raad
- Department of Medicine, State University of New York at Buffalo, NY, USA
| | - Jason Hallman
- Department of Gastroenterology, State University of New York at Buffalo, NY, USA
| | - Jan Novak
- Department of Gastroenterology, State University of New York at Buffalo, NY, USA
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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: 0.3] [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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Ikenberry SO, Jue TL, Anderson MA, Appalaneni V, Banerjee S, Ben-Menachem T, Decker GA, Fanelli RD, Fisher LR, Fukami N, Harrison ME, Jain R, Khan KM, Krinsky ML, Maple JT, Sharaf R, Strohmeyer L, Dominitz JA. Management of ingested foreign bodies and food impactions. Gastrointest Endosc 2011; 73:1085-91. [PMID: 21628009 DOI: 10.1016/j.gie.2010.11.010] [Citation(s) in RCA: 451] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2010] [Accepted: 11/05/2010] [Indexed: 02/08/2023]
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Mönkemüller K, Neumann H, Malfertheiner P, Fry LC. Advanced colon polypectomy. Clin Gastroenterol Hepatol 2009; 7:641-52. [PMID: 19281865 DOI: 10.1016/j.cgh.2009.02.032] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2008] [Revised: 02/16/2009] [Accepted: 02/21/2009] [Indexed: 02/07/2023]
Affiliation(s)
- Klaus Mönkemüller
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University, Leipziger Strasse 44, Magdeburg 39120, Germany.
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Chen YH, Liao WC, Hou MC, Lin HC, Lee SD. Esophageal food impaction: a homemade suction tube attached to esophagogastroduodenoscopy for food bolus removal. J Chin Med Assoc 2008; 71:635-8. [PMID: 19114328 DOI: 10.1016/s1726-4901(09)70006-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The most common esophageal foreign body in adults is impacted food bolus. Polypectomy snares, Dormia baskets, retrieval nets, rat-tooth forceps, alligator forceps or polyp graspers are usually used to remove it. Here, we report the case of a 78-year-old woman whose esophagogastroduodenoscopy (EGD) showed a firm goose liver impacted tightly in the lower esophagus; all of the above-mentioned retrieval instruments could not remove it. We used a homemade device by attaching a modified nasogastric tube to an EGD and successfully removed the goose liver by suction under endoscopic visualization. The method is very effective to remove firm and tightly impacted materials in a narrow lumen. When the usual retrieval instruments fail, a homemade suction tube attached to an EGD is an alternative.
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Affiliation(s)
- Yu-Hsin Chen
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC
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Ye F, Feng Y, Lin J. Retrieval of colorectal polyps following snare polypectomy: Experience of the multiple-suction technique in 602 cases. Int J Colorectal Dis 2008; 23:431-6. [PMID: 18185937 DOI: 10.1007/s00384-007-0429-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/13/2007] [Indexed: 02/04/2023]
Abstract
BACKGROUND Retrieving colorectal polyp after endoscopic snare polypectomy is time consuming and possibly incurs a failure. The aim of the study was to assess the effectiveness of the multiple-suction (M-S) technique for retrieving a variety of polyps. MATERIALS AND METHODS Four hundred and nine cases received endoscopic snare polypectomy from January 2003 to January 2007 were reviewed. The resected polyps were retrieved by M-S technique, in which suction regarded as the leading technique, was taken in combination with channel occlusion, trap, snare, and grasping forcep. Time of cecal intubation and of polypectomy, total examination time, shape, size, location, and number of polyp(s) were recorded. Retrieval time and polyp lost rate were also noted. RESULTS A total of 602 polyps more than 3 mm in diameter underwent snare polypectomy. There were 96.7% (582/602) of polyps retrieved by the M-S technique. The mean retrieval time was 1.5 +/- 0.6 min. Time of polypectomy, retrieval time, and total examination time were significantly positive correlative with the number of polyps (P < 0.05). In a univariate analysis, longer retrieval time was significantly associated with larger polyps, more distant polyps from the anus, and a greater number of polyps, while higher polyp lost rate was significantly associated with sessile polyp, smaller polyps, and a greater number of polyps. In a multivariate analysis, retrieval time level (< or = 2.0 or >2.0 min) was linked to the number of polyps. CONCLUSIONS The M-S technique is proved to be reliable when used in the majority cases of colorectal polyp retrieval. In retrieving too many polyps, the M-S technique is time consuming, and hence, additional methods should be applied to improve its retrieval effectiveness.
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Affiliation(s)
- Feng Ye
- Department of Colorectal Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Qinchun Road 79, 310003 Hangzhou, People's Republic of China
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Sutcliffe RP, Rohatgi A, Forshaw MJ, Mason RC. Recurrent laryngeal nerve palsy due to impacted dental plate in the thoracic oesophagus: case report. World J Emerg Surg 2007; 2:30. [PMID: 17997831 PMCID: PMC2194669 DOI: 10.1186/1749-7922-2-30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2007] [Accepted: 11/12/2007] [Indexed: 11/23/2022] Open
Abstract
Background Retained oesophageal foreign bodies must be urgently removed to prevent potentially serious complications. Recurrent laryngeal nerve palsy is rare and has not been reported in association with a foreign body in the thoracic oesophagus. Case presentation We present a case of a dental plate in the thoracic oesophagus that caused high dysphagia. Delayed diagnosis led to a recurrent laryngeal nerve palsy, which persisted despite successful surgical removal of the foreign body. Conclusion Oesophagoscopy is essential to fully assess patients with persistent symptoms after foreign body ingestion, irrespective of the level of dysphagia. Recurrent laryngeal nerve palsy may indicate impending perforation and should prompt urgent evaluation and treatment.
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Affiliation(s)
- Robert P Sutcliffe
- Department of General Surgery, Guy's and St Thomas' NHS Trust, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, UK.
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Carpenter S, Petersen BT, Chuttani R, Croffie J, DiSario J, Liu J, Mishkin D, Shah R, Somogyi L, Tierney W, Song LMWK. Polypectomy devices. Gastrointest Endosc 2007; 65:741-9. [PMID: 17397841 DOI: 10.1016/j.gie.2006.10.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Abstract
The spectrum of gastrointestinal (GI) foreign bodies includes food bolus impaction in the esophagus, nonfood objects that are swallowed, and various objects that may be inserted into the rectum. The risk depends upon the type of object and its location. Fortunately, 80% to 90% of ingested foreign bodies will pass without intervention. Objects with sharp edges or pointed tips have the highest risk of complications, up to 35%. All objects impacted in the esophagus require urgent or emergent treatment. Rectal foreign bodies are usually removable transanally, although general anesthesia and operative intervention sometimes are required.
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Affiliation(s)
- Milton T Smith
- Gastroenterology Service, Walter Reed Army Medical Center, 6900 Georgia Avenue, Northwest, Washington, DC 20307, USA.
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Li ZS, Sun ZX, Zou DW, Xu GM, Wu RP, Liao Z. Endoscopic management of foreign bodies in the upper-GI tract: experience with 1088 cases in China. Gastrointest Endosc 2006; 64:485-92. [PMID: 16996336 DOI: 10.1016/j.gie.2006.01.059] [Citation(s) in RCA: 151] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2005] [Accepted: 01/15/2006] [Indexed: 02/08/2023]
Abstract
BACKGROUND Reports on endoscopic management of ingested foreign bodies of the upper-GI tract in China are scarce. OBJECTIVE To report our experience and outcome in the management of ingestion of foreign bodies in Chinese patients. SETTING AND PATIENTS Between January 1980 and January 2005, a total of 1088 patients (685 men and 403 women; age range, 1 day to 96 years old) with suspected foreign bodies were admitted to our endoscopy center. INTERVENTIONS All patients underwent endoscopic procedure after admission. MAIN OUTCOME MEASUREMENTS Demographic and endoscopic data, including age, sex, and referral sources of patients, types, number and location of foreign bodies, associated upper-GI diseases, endoscopic methods, and accessory devices for removal of foreign bodies were collected and analyzed. RESULTS A total of 1090 foreign bodies were found in 988 (90.8%) patients. The types of foreign bodies varied greatly: mainly food boluses, coins, fish bones, dental prostheses, or chicken bones. The foreign bodies were located in the pharynx (n = 12), the esophagus (n = 577), the stomach (n = 441), the duodenum (n = 50), and the surgical anastomosis (n = 10). The associated GI diseases (n = 88) included esophageal carcinoma (33.0%), stricture (23.9%), diverticulum (15.9%), postgastrectomy (11.4%), hiatal hernia (10.2%), and achalasia (5.7%). A rat-tooth forceps and a snare were the most frequently used accessory devices. The success rate for foreign-body removal was 94.1% (930/988). CONCLUSIONS Ingestion of foreign bodies is a common clinic problem in China. Endoscopy procedures are frequently performed, and a high proportion of patients with foreign bodies require endoscopic intervention.
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Affiliation(s)
- Zhao-Shen Li
- Department of Gastroenterology, Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
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Abstract
Patients with esophageal foreign bodies require prompt diagnosis and therapy. The first tasks are to determine the type of object, time since ingestion, location of the object, and the likelihood of associated complications. Patients who have evidence of complete esophageal occlusion or who have ingested a sharp or pointed object require urgent treatment due to the increased risk of complications. Button batteries are particularly injurious in the esophagus and should be removed immediately. Coins in the esophagus should also be removed; however, a brief period of observation is appropriate for coins in the distal esophagus, as some will pass spontaneously. Flexible endoscopy is the therapeutic modality of choice for most patients. The key principles for endoscopic management of esophageal foreign bodies are to protect the airway, to maintain control of the object during extraction, and to avoid causing additional damage. Endotracheal intubation is sometimes necessary, especially in younger children and those at higher risk for aspiration. The use of devices such as an esophageal overtube and a latex protector hood may facilitate safer extraction of sharp/pointed objects. Patients with food impactions usually require treatment of an associated structural lesion of the esophagus.
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Affiliation(s)
- Milton T Smith
- Walter Reed Army Medical Center, 6900 Georgia Avenue, NW, Washington, DC 20307-5001, USA.
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Abstract
This section focuses on intraprocedural steps that can improve endoscopic efficiency. Contributors to procedural efficiency and inefficiency are considered. The limitations to enhancing efficiency are presented. Strategies for incorporating contributors to efficiency including techniques, technologies, accessories, and attitudes are presented.
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Affiliation(s)
- Gregory G Ginsberg
- University of Pennsylvania School of Medicine, 3400 Spruce Street, Philadelphia, PA 10104, USA.
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Eisen GM, Baron TH, Dominitz JA, Faigel DO, Goldstein JL, Johanson JF, Mallery JS, Raddawi HM, Vargo JJ, Waring JP, Fanelli RD, Wheeler-Harbough J. Guideline for the management of ingested foreign bodies. Gastrointest Endosc 2002; 55:802-6. [PMID: 12024131 DOI: 10.1016/s0016-5107(02)70407-0] [Citation(s) in RCA: 345] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
This is one of a series of statements discussing the utilization of gastrointestinal endoscopy in common clinical situations. The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy prepared this text. In preparing this guideline, a MEDLINE literature search was performed, and additional references were obtained from the bibliographies of the identified articles and from recommendations of expert consultants. When little or no data exist from well-designed prospective trials, emphasis is given to results from large series and reports from recognized experts. Guidelines for appropriate utilization of endoscopy are based on a critical review of the available data and expert consensus. Further controlled clinical studies are needed to clarify aspects of this statement, and revision may be necessary as new data appear. Clinical consideration may justify a course of action at variance to these recommendations.
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Abstract
BACKGROUND All colon polyps removed during colonoscopy should be recovered and submitted for histopathologic analysis. Published information is scant regarding techniques and devices for retrieval of polyps after polypectomy. The Roth Retrieval Net is a novel device that has been used to retrieve foreign bodies from the GI tract, but its use as a polyp retrieval device has not previously been described. METHODS A chart review was conducted over a 7-month period by one gastroenterologist in an office setting of all patients who had polyps retrieved after piecemeal polypectomy by using the Roth Retrieval Net. RESULTS All resected polyps were completely retrieved in a time-efficient manner. Histopathologic evaluation was not compromised by the use of this device. CONCLUSIONS The Roth Retrieval Net is well suited for retrieval of multiple polyp fragments after colonoscopic polypectomy.
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Affiliation(s)
- K Miller
- Division of Gastroenterology, Department of Medicine, Mount Sinai Hospital, New York, NY, USA
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