Endoscopic Retrieval Devices

Endoscopic Removal of a Duodenal-Perforating Leg of Glasses with Dormia Basket

Ingestion of foreign bodies is common in clinical practice. Most ingested foreign bodies will pass through the gastrointestinal (GI) tract without any problems. While GI tract injury due to the ingested foreign body such as a toothpick, a fishbone, a date pit, or a chicken bone, is common, duodenal perforation is rare. In this report, our experience with this rare entity is shared. We present a 38-year-old male patient with GI tract perforation in the bulbus of the duodenum due to a leg of glasses. The patient was admitted to our hospital with severe abdominal pain. Right upper quadrant tenderness was detected at physical examination, and leukocytosis on the laboratory test results. Plain X-ray and computerized tomography showed an ingested foreign body in the bulbus of the duodenum. A leg of glasses perforating the duodenum was removed with endoscopy. The patient was managed nonoperatively, and discharged without any complications on the eighth day after endoscopy. Endoscopic removal and nonoperative management may be feasible in carefully selected patients with duodenal-perforating foreign bodies.

Bronchoscopic retrieval of a bullet using a Dormia basket: a case report

Introduction

Penetrating bullet injury to the trachea is a rarity, and therefore standardized procedure for injury management and foreign body removal has not been established. This is a case report describing retrieval of a bullet from the bronchus intermedius using flexible bronchoscopy and a Dormia basket.

Case presentation

A 19-year-old African American woman presented with a gunshot wound to her right neck just lateral to the sternal head of the sternocleidomastoid muscle and just superior to the clavicle. Imaging showed a bullet lodged within her right bronchus with no evidence of vascular injury. Fiberoptic flexible bronchoscopy in combination with biopsy forceps and a Dormia basket were used for bullet removal.

Conclusions

Removal of foreign bodies from the airway is essential in order to avoid complications such as tracheal stenosis, pneumonia, bronchiectasis and foreign body migration. To the best of our knowledge, this case is one of only several cases reporting the use of flexible bronchoscopy for bullet removal, and this is the only case to describe the use of a Dormia basket. This case demonstrates bronchoscopy as a safe and effective means of minimally invasive removal of a bullet fragment from the bronchus in a trauma setting.

Endoscopic management of ingested foreign bodies and food impactions

Endoscopy plays a major role in the management of foreign bodies and food impactions. Because of their frequent occurrence and potential for complications, it is important for the gastroenterology nurse and associate to gain an understanding of the incidence, diagnosis, and management of patients who present with ingested foreign bodies or food impaction. This article summarizes the clinical approach to patient: assessment, preparation for endoscopic procedure, preparation of endoscopic accessories, and follow-up care. Finally, an interesting case presentation highlights key components of caring for patients requiring endoscopic intervention.

Update on foreign bodies in the esophagus: diagnosis and management

Foreign body impaction in the esophagus is an important emergency that carries significant morbidity and potential mortality. The most common cause of esophageal foreign body obstruction in adults is meat bolus impaction above a pre-existing distal esophageal (mucosal) ring, peptic or malignant esophageal stricture, or eosinophilic esophagitis. Immediate evaluation of the airway, assessment of the urgency of removal, radiological evaluation to localize the object, endoscopic or surgical retrieval, and subsequent monitoring for complications are essential steps in the management.

Technical and equipment challenges for laparoendoscopic single-site surgery and natural orifice transluminal endoscopic surgery

Laparoendoscopic single-site surgery (LESS) and natural orifice transluminal endoscopic surgery (NOTES™) are new approaches to minimally invasive surgery. A number of technical challenges need to be overcome and new developments of equipment are required before widespread acceptance of either modality occurs. In this paper we discuss novel approaches and innovations as well as review examples of equipment and platforms that have previously been used for LESS and NOTES. Emphasis is given to urological applications.