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Extraction of esophageal foreign body with burrowing technique
VIDEOGIE Todd H. Baron, MD, G. S. Raju, MD, Editors for VideoGIE
Extraction of esophageal foreign body with burrowing technique
Figure 1. Garlic clove with a Fogarty balloon through it at the moment of extraction.
A 32-year-old man with no medical history (including previous food impaction or esophageal disease) experienced sudden dysphagia after ingestion of a garlic clove. At the arrival at our unit the patient showed symptoms of esophageal obstruction. We performed a gastroscopy, observing a white foreign body impacted in the proximal esophagus. We tried to mobilize it with insufflation and mild pushing pressure with no success. Because of the complete impaction, we were not able to pass a Roth net, a polypectomy snare, or a guidewire between the garlic and the esophageal wall. At this point we started the burrowing technique, which consists of creating a tunnel through the garlic at its center by using argon plasma coagulation (APC). To determine whether APC had dissected through completely and to prevent mucosal injury, we applied APC for 1 to 2 seconds and then gently pushed the probe until we felt the probe easily advance. Once the tunnel was completed, we passed a Fogarty balloon through the tunnel, inflated the balloon,
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and then pulled it back (Fig. 1, Video 1, available online at www.giejournal.org). Accidental foreign body ingestion is a frequent cause of emergent endoscopy that at times, depending on the object and location, is a challenging procedure that forces the endoscopist to imagine new methods. DISCLOSURE All authors disclosed no financial relationships relevant to this publication. Monder Abu-Suboh Abadia, MD, Joan Dot Bach, MD, Miquel Masachs Peracaula, MD, Jordi Armengol Miró, MD, Josep Ramon Armengol Miró, MD, Hospital Vall d’Hebron WIDER Barcelona, Barcelona, Spain http://dx.doi.org/10.1016/j.gie.2016.02.037
Volume
-,
No.
-
: 2016 GASTROINTESTINAL ENDOSCOPY 1
Extraction of esophageal foreign body with burrowing technique
Figure 1. Garlic clove with a Fogarty balloon through it at the moment of extraction.
A 32-year-old man with no medical history (including previous food impaction or esophageal disease) experienced sudden dysphagia after ingestion of a garlic clove. At the arrival at our unit the patient showed symptoms of esophageal obstruction. We performed a gastroscopy, observing a white foreign body impacted in the proximal esophagus. We tried to mobilize it with insufflation and mild pushing pressure with no success. Because of the complete impaction, we were not able to pass a Roth net, a polypectomy snare, or a guidewire between the garlic and the esophageal wall. At this point we started the burrowing technique, which consists of creating a tunnel through the garlic at its center by using argon plasma coagulation (APC). To determine whether APC had dissected through completely and to prevent mucosal injury, we applied APC for 1 to 2 seconds and then gently pushed the probe until we felt the probe easily advance. Once the tunnel was completed, we passed a Fogarty balloon through the tunnel, inflated the balloon,
www.giejournal.org
and then pulled it back (Fig. 1, Video 1, available online at www.giejournal.org). Accidental foreign body ingestion is a frequent cause of emergent endoscopy that at times, depending on the object and location, is a challenging procedure that forces the endoscopist to imagine new methods. DISCLOSURE All authors disclosed no financial relationships relevant to this publication. Monder Abu-Suboh Abadia, MD, Joan Dot Bach, MD, Miquel Masachs Peracaula, MD, Jordi Armengol Miró, MD, Josep Ramon Armengol Miró, MD, Hospital Vall d’Hebron WIDER Barcelona, Barcelona, Spain http://dx.doi.org/10.1016/j.gie.2016.02.037
Volume
-,
No.
-
: 2016 GASTROINTESTINAL ENDOSCOPY 1