M A Mirhej1, J Koch, J Stansell. 1. Division of Gastroenterology, Hepatology, and Clinical Nutrition, and the AIDS Program, San Francisco General Hospital, San Francisco, California, USA.
Abstract
BACKGROUND: Foreign body ingestions are common, especially in pediatric, edentulous, psychiatric, and incarcerated populations. For the 20% of foreign bodies that do not pass spontaneously through the gastrointestinal tract, removal using modern, flexible endoscopes has become routine. METHODS: We describe the successful endoscopic removal of a ring-type or "closed loop" foreign body by means of a novel technique. Utilizing a nasogastric tube inserted alongside the endoscope, a guidewire inserted through the tube is directed through the ring with a "rat-tooth" grasping forceps passed through the accessory channel of the endoscope. The wire is snared and pulled up through the endoscope creating a "U," with both ends of the wire outside of the patient. The nasogastric tube, endoscope, and foreign body may then be removed safely. RESULTS: The technique was easy to perform and the foreign body was removed without complication. CONCLUSIONS: Using the U-wire technique, ring-type foreign bodies may be readily and safely removed.
BACKGROUND: Foreign body ingestions are common, especially in pediatric, edentulous, psychiatric, and incarcerated populations. For the 20% of foreign bodies that do not pass spontaneously through the gastrointestinal tract, removal using modern, flexible endoscopes has become routine. METHODS: We describe the successful endoscopic removal of a ring-type or "closed loop" foreign body by means of a novel technique. Utilizing a nasogastric tube inserted alongside the endoscope, a guidewire inserted through the tube is directed through the ring with a "rat-tooth" grasping forceps passed through the accessory channel of the endoscope. The wire is snared and pulled up through the endoscope creating a "U," with both ends of the wire outside of the patient. The nasogastric tube, endoscope, and foreign body may then be removed safely. RESULTS: The technique was easy to perform and the foreign body was removed without complication. CONCLUSIONS: Using the U-wire technique, ring-type foreign bodies may be readily and safely removed.