The management of foreign affairs of the GI tract

Abstract

The flexible fiberoptic endoscope has not been employed consistently in the removal of foreign bodies from the gastrointestinal tract due to size limitations of the forceps and biopsy channel. The following report describes a technique for extracting large irregular objects from the upper-gastrointestinal tract, employing the polypectomy snare. It is a safe and reproducible procedure for the careful extraction of impacted objects.

Endoscopic identification and removal of an unusual symptomatic colonic foreign body

“…Fiberoptic endoscopy has been shown to be useful in the removal of foreign bodies from the upper gastrointestinal tract (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)17). e r , are infrequently called upon to retrieve foreign objects from the colon because objects inserted through the anus seldom lodge in the colon higher than the reach of the sigmoidoscope (2) and ingested foreign bodies usually pass through the colon without complication after traversing the small bowel (14).…”

“…Flexible fiberoptic endoscopes were initially thought to be of only limited use for retrieving foreign bodies since the only lumen through which foreign bodies could be passed was the tiny biopsy forceps channel. Recently however, a number of reports have appeared which describe the removal of a variety of foreign objects including a sewing needle (4), an open safety pin (5), rubber catheters and knotted nasogastric tubes (6, 7), a toothbrush (8), a toothpick (9), pieces of coat hanger wire (10), a 5-centimeter hat pin (11), and a chicken bone (12), as well as an artichoke heart, a prune pit, a hypodermic needle, a thermometer, and a gallstone (13), from the upper gastrointestinal tract with flexible fiberoptic endoscopes. Such reports provide con-vincing evidence that fiberoptic endoscopy can be highly effective in locating and removing foreign bodies from the upper gastrointestinal tract.…”

Food Accidents

“…Removal of foreign bodies, in fact, was one of the primary concerns during the development of endoscopy. The original straight endoscope, however, with its large forceps and biopsy channel, had itself been a significant cause of perforation with associated morbidity and mortality (Katz, 1969;McCaffery and Lilly, 1975). The removal of foreign bodies was questioned as a primary use of endoscopy.…”

“…Another technique developed to adapt the flexible endoscope to removal of large foreign bodies has been the polypetomy snare. It can secure large objects, grasping and removing them under direct vision with the fiberendoscope (McCaffery and Lilly, 1975;Roseman, 1978). Due to the refinements in endoscopic techniques, surgery is currently rarely indicated in the retrieval of foreign bodies from the gastrointestinal tract.…”

Foreign Body Extraction Device

“…Foreign bodies in the gastrointestinal tract, are a common problem [1,2]. Rarely, they may cause obstruction either of the pylorus, or terminal ileum.…”