Endoscopy 2019; 51(04): S248
DOI: 10.1055/s-0039-1681917
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Stomach and small intestine ePosters
Georg Thieme Verlag KG Stuttgart · New York

A RARE CASE OF BURIED AND PERFORATING SHARP FOREIGN BODY (METAL PIN) FROM ANTRUM TO GB FOSSA – REMOVED USING ESD

P Desai
1   Endoscopy, Surat Institute of Digestive Sciences, Surat, India
,
M Kabrawala
1   Endoscopy, Surat Institute of Digestive Sciences, Surat, India
,
R Mehta
1   Endoscopy, Surat Institute of Digestive Sciences, Surat, India
,
P Kalra
2   Surat Institute of Digestive Sciences, Surat, India
,
C Patel
1   Endoscopy, Surat Institute of Digestive Sciences, Surat, India
,
S Nandwani
2   Surat Institute of Digestive Sciences, Surat, India
,
R Prajapati
2   Surat Institute of Digestive Sciences, Surat, India
,
N Patel
2   Surat Institute of Digestive Sciences, Surat, India
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 
 

    Case:

    A 27 year old male.

    Abdominal pain over right hypochondrium.

    Nausea.

    Vomiting- one episode, non-bilious.

    H/o accidental ingestion of metal pin.

    Patient was admitted at government medical college for 15 days.

    Close clinical observation and conservative medical management.

    Multiple serial X-rays- s/o persistent position of FB in stomach.

    Discharged on supportive medical treatment.

    Persistent symptoms- Referred to our institute.

    CT Findings:

    NCCT revealed a Foreign body in the pre pyloric region of the stomach with its distal end extending into the gall bladder fossa with very minimal adjacent free fluid and few air foci s/o perforation.

    Method:

    Endoscopy revealed a bulge in the antrum with mucosal cover and the FB was imbedded deep in the bulge. We located it under fluoroscopy, marked the tip and then marked with a dual knife surround the area of the tip. Did a deep mucosal incision with ESD technique over the marked tip. After deep dissection we probed the area with a rat tooth forceps and again taking the help of fluoroscopy we caught the tip of the needle and removed it safely. There was little ooze from the raw area and hemostasis was secured with gold probe coagulation. Fluoroscopy confirmed no free CO2 leak from the area.

    Conclusion:

    ESD technique was useful in removal of a buried and perforating sharp foreign body from the antrum while using fluoroscopy guidance. The technique shows the importance of using resources at hand to remove difficult foreign bodies in the GI tract.


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