Subscribe to RSS
DOI: 10.1055/a-1524-1218
Endoscopic removal of an entirely embedded esophageal fishbone
A 65-year-old man was referred to our hospital with a 3-day history of pain in the upper esophagus after eating fish. Subsequent computed tomography (CT) showed a fishbone in the upper esophagus without any injury to the surrounding vessels. Emergency endoscopy was performed under general anesthesia. During the procedure, we tried to remove the fishbone with biopsy forceps through a high-definition gastroscope (GIF-Q260J; Olympus, Tokyo, Japan). However, only congestion and edema of the local esophagus were confirmed and the fishbone could not be found ([Fig. 1 a]), suggesting that it had become entirely embedded in the esophageal wall. Further evaluation of the location of the fishbone was completed based on the endoscopic findings, CT scan, and three-dimensional image reconstruction ([Fig. 2]). After full communication with the patient, a second try was made ([Video 1]). In this process, a hook knife was used to create an incision ([Fig. 1 b]) and the fishbone was partially exposed ([Fig. 1 c]). Next, the 3-cm-long fishbone was successfully extracted using grasping forceps ([Fig.1 d, f]), without closing the esophageal incision ([Fig. 1 e]). The whole endoscopic procedure only took about 10 minutes as an outpatient procedure; the patient was discharged immediately and was allowed a liquid diet 6 hours after treatment. The operative and postoperative periods were uneventful, without any complications.




Video 1 Endoscopic removal of an entirely embedded esophageal fishbone.
Quality:
Although the fishbone in the present case was successfully removed endoscopically, endoscopic removal of entirely embedded foreign bodies still remains challenging [1]. Therefore, it is suggested that impacted foreign bodies should be removed within 24 hours, no longer, which will increase the likelihood of successful removal and decrease the risk of complications [2]. Meanwhile, in order to ensure the safety of the operation, it is highly critical to identify the location of the foreign body and evaluate its location in relation to the surrounding organs and vessels before removing it endoscopically [3].
Endoscopy_UCTN_Code_TTT_1AO_2AL
Endoscopy E-Videos is an open access online section, reporting on interesting cases and new techniques in gastroenterological endoscopy. All papers include a high quality video and all contributions are freely accessible online. Processing charges apply (currently EUR 375), discounts and wavers acc. to HINARI are available.
This section has its own submission
website at
https://mc.manuscriptcentral.com/e-videos
#
Competing interests
The authors declare that they have no conflict of interest.
* Wei Liu and Long He are co-first authors.
-
References
- 1 Wang Y, Liu ZQ, Xu XY. et al. Endoscopic removal of entirely embedded esophagus‐penetrating foreign bodies (with video). J Gastroenterol Hepatol 2021; [Published online ahead of print, 31 Dec 2020]
- 2 Birk M, Bauerfeind P, Deprez PH. et al. Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2016; 48: 489-496
- 3 Tan Y, Chu Y, Liu D. et al. Delayed massive bleeding caused by an ingested fish bone. Endoscopy 2015; 47: E569-E570
Corresponding author
Publication History
Article published online:
02 July 2021
© 2021. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Wang Y, Liu ZQ, Xu XY. et al. Endoscopic removal of entirely embedded esophagus‐penetrating foreign bodies (with video). J Gastroenterol Hepatol 2021; [Published online ahead of print, 31 Dec 2020]
- 2 Birk M, Bauerfeind P, Deprez PH. et al. Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2016; 48: 489-496
- 3 Tan Y, Chu Y, Liu D. et al. Delayed massive bleeding caused by an ingested fish bone. Endoscopy 2015; 47: E569-E570



