VIDEOGIE Todd H. Baron, MD, G. S. Raju, MD, Editors for VideoGIE
Retrograde single-balloon enteroscopy for the removal of an ileal foreign body
Figure 1. Triangular bony fragment extracted from the distal ileum.
A 51-year-old obese woman presented with acute, severe epigastric abdominal pain. She was hemodynamically stable with unrevealing lab work. A CT of the abdomen and pelvis revealed a radiopaque foreign body in the distal ileum with penetration of the ileal wall and a focus of extraluminal gas; there was no abscess or pneumoperitoneum. We performed a retrograde single-balloon enteroscopy (SBE) with CO2 insufflation by inserting the endoscope through the rectum, advancing to the cecum, and intubating the ileocecal valve. At approximately 20 cm proximal to the valve, a bony fragment was seen with mucosal penetration. The fragment was extracted with forceps and withdrawn into the overtube; the SBE apparatus was then slowly withdrawn (Fig. 1; Video 1, available online at www. giejournal.org). The patient did well both during and after the procedure and was discharged home 2 days later. At 6-week follow-up, the patient was without symptoms. Deep enteroscopy can be used therapeutically in both the antegrade and retrograde fashion. We demonstrate the successful use of retrograde SBE for the removal
www.giejournal.org
of an accidental bony ingestion as a surgery-sparing intervention. In this case, the overtube of the singleballoon platform was used as a barrier to minimize trauma to the mucosa during withdrawal.
DISCLOSURE The authors disclosed no financial relationships relevant to this article. Anoop Prabhu, MD1, Susana Gonzalez, MD1, Umut Sarpel, MD2, Christopher J. DiMaio, MD, FASGE1, Department of Medicine, Division of Gastroenterology (1), Department of Surgery, Division of Surgical Oncology (2), Icahn School of Medicine at Mount Sinai, New York, New York, USA
http://dx.doi.org/10.1016/j.gie.2014.08.004
Volume
-,
No.
-
: 2014 GASTROINTESTINAL ENDOSCOPY 1
Retrograde single-balloon enteroscopy for the removal of an ileal foreign body
Figure 1. Triangular bony fragment extracted from the distal ileum.
A 51-year-old obese woman presented with acute, severe epigastric abdominal pain. She was hemodynamically stable with unrevealing lab work. A CT of the abdomen and pelvis revealed a radiopaque foreign body in the distal ileum with penetration of the ileal wall and a focus of extraluminal gas; there was no abscess or pneumoperitoneum. We performed a retrograde single-balloon enteroscopy (SBE) with CO2 insufflation by inserting the endoscope through the rectum, advancing to the cecum, and intubating the ileocecal valve. At approximately 20 cm proximal to the valve, a bony fragment was seen with mucosal penetration. The fragment was extracted with forceps and withdrawn into the overtube; the SBE apparatus was then slowly withdrawn (Fig. 1; Video 1, available online at www. giejournal.org). The patient did well both during and after the procedure and was discharged home 2 days later. At 6-week follow-up, the patient was without symptoms. Deep enteroscopy can be used therapeutically in both the antegrade and retrograde fashion. We demonstrate the successful use of retrograde SBE for the removal
www.giejournal.org
of an accidental bony ingestion as a surgery-sparing intervention. In this case, the overtube of the singleballoon platform was used as a barrier to minimize trauma to the mucosa during withdrawal.
DISCLOSURE The authors disclosed no financial relationships relevant to this article. Anoop Prabhu, MD1, Susana Gonzalez, MD1, Umut Sarpel, MD2, Christopher J. DiMaio, MD, FASGE1, Department of Medicine, Division of Gastroenterology (1), Department of Surgery, Division of Surgical Oncology (2), Icahn School of Medicine at Mount Sinai, New York, New York, USA
http://dx.doi.org/10.1016/j.gie.2014.08.004
Volume
-,
No.
-
: 2014 GASTROINTESTINAL ENDOSCOPY 1
