Endoscopic foreign body retrieval

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The retrieval of endoscopic foreign objects refers to the removal of digested objects from the esophagus, stomach and duodenum by endoscopic techniques. It does not involve surgery, but includes a variety of techniques used through the gastroscope to grip the foreign object, manipulate them, and remove them while protecting the esophagus and trachea. This is especially important for children, people with mental illness, and prison inmates because these groups have high levels of foreign body consumption.

Commonly swallowed objects include coins, buttons, batteries, and small bones (like fish bones), but can include more complex objects, such as glasses, spoons, and toothbrushes (see figure).

Video Endoscopic foreign body retrieval

Indications and contraindications

Some patients at risk of ingesting foreign bodies may not be able to give a history of accurate drug consumption, either due to age or mental illness. It is important that the doctors treating these patients recognize the symptoms of oesophageal foreign impaction that require immediate intervention. Most often, this includes drooling and inability to swallow saliva, neck tenderness, regurgitation of food, stridor and shortness of breath if there is compression of the trachea.

There are some situations where endoscopic techniques are not indicated, such as for small blunt objects less than 2.5 cm that have entered the stomach (as this usually does not block elsewhere), when there is perforation of the esophagus or mediastinitis (inflammation of the structures around the esophagus) , and for bags or condoms containing ingested narcotics, because of the risk of an overdose if they are ruptured.

Foreign bodies must be removed from the esophagus within 24 hours after swallowing due to high risk of complications.

Maps Endoscopic foreign body retrieval

Non-invasive testing

Before endoscopy, efforts should be made to find foreign objects with X-rays or other non-invasive techniques. For radio-opaque objects, X-rays from the neck, chest and abdomen can be used to search for foreign objects and assist endoscopy. Alternative approaches, including the use of metal detectors, have also been described.

X-rays are also useful for identifying the type of foreign body ingested and the complications of ingesting foreign objects, including mediastinitis and esophageal perforation.

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Endoscopy

Endoscopic retrieval involves the use of a gastroscope or camera of a fiber-optic charge device. This tool is a long tube, which is passed through the mouth to the esophagus and stomach to identify a foreign object or body. This procedure is usually performed in the subconscious sedation. Many techniques have been described to remove foreign objects from the stomach and esophagus. Usually esophagus is protected by overtube (plastic tube with varying length), in which the gastroscope and the object taken is passed.

Once a foreign object has been identified with the gastroscope, various devices can be passed through the gastroscope to understand or manipulate foreign objects. The devices used include forceps, which come in various shapes, sizes and grips, snares, and oval loops that can be pulled from outside the gastroscope to the lasso object, as well as the Roth basket (mesh nets that can be closed to trap small objects), and the magnets are placed in the tip of the scope or at the end of the orogastric tube. Some techniques have been described that use foley catheters to trap objects, or use two meshes to orient foreign bodies.

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Alternative Method

In Veterinary Medicine or when no Endoscopy is available for extracting foreign objects economically without surgery very often, a Hartmann Alligator throw is used

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See also

• Bezoar
• The Schatzki Ring

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References

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External links

• Esophageal Coin Topics MedPix

Source of the article : Wikipedia