Endoscopy; Foreign Bodies; Stomach
Foreign body ingestion is an important problem in adult with psychological disorders. In literature ingestion such as fish bone, fork and several metallic elements were reported. The first attempt, after diagnosis, is endoscopic removal11 Goh YM, Shapey IM, Riyad K. Gastric perforation secondary to ingestion of a plastic bag. Ann R Coll Surg Engl. 2016 Feb;98(2):e29-30.. Surgical approach is necessary in it´s failure. In this paper is presented a successful endoscopic removal of a wristwatch which was ingested by a deaf patient.
A 25-year-old male deaf patient was admitted in emergency department with complaint of abdominal pain and unable to communicate anything of his clinical history. Physical examination was normal except an epigastric tenderness. Laboratory results were normal. Direct radiography revealed a circular shaped metallic object in stomach and other several metallic objects in gastrointestinal tract (Figure 1A). An emergent gastrointestinal endoscopy was planned and during the procedure a wristwatch in the stomach was diagnosed and successfully removed with an esophageal overtube approach under direct endoscopic vision (Figure 1B).
A) Abdominal plain graph was showed a watch; B) endoscopic image of the watch in the stomach
A delay in the diagnosis an dextraction of sharp or large sized foreign objects can lead to severe complications including mucosal laceration, obstruction, hemorrhage, and perforation. Therapeutic esophagogastroduodenoscopy with an esophageal overtube should be the first choice retrieval of large sized foreign bodies to avoid mucosal laceration, perforation and the surgical treatment.
1Goh YM, Shapey IM, Riyad K. Gastric perforation secondary to ingestion of a plastic bag. Ann R Coll Surg Engl. 2016 Feb;98(2):e29-30.
2Ikenberry SO, Jue TL, Anderson MA, et al. Management of ingested foreign bodies and food impactions. Gastrointest Endosc 2011;73: 1085-9.
3Li ZS, Sun ZX, Zou DW, et al. Endoscopic management of foreign bodies in theupper-GI tract: experiencewith 1088 cases in China. Gastrointest Endosc 2006;64:485-92.
Publication in this collection
26 Aug 2019
Date of issue
01 June 2017
06 Feb 2019