Chiu King-Wah, Lu Lung-Sheng, Wu Tsung-Chin, Chiou Shue-Shian
From the Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital (K-WC, L-SL, T-CW, S-SC); and College of Medicine, Chang Gung University, Taiwan, Republic of China (K-WC).
Medicine (Baltimore). 2015 May;94(17):e796. doi: 10.1097/MD.0000000000000796.
A 57-year-old man presented to the hospital because of swallowing of a small marble precipitated by a hallucination. He subsequently developed chest discomfort. He had a history of psychiatric problem and an esophageal corrosive injury complicated by stricture of the middle esophagus.This report describes the novel idea of endoscopic intervention for the retrieval of an esophageal foreign body. Its inventiveness and the use of limited resources, by adapting a 30-mm aseptic common tubing into an endoscopic retrieving device, make the method novel. This novel low-cost endoscopic cap (NLCEC) was adapted to 25 mm of the front end of the endoscope, with 5 mm maintained for the soft part to prevent esophageal mucosal injury during the retrieval process. An 8-mm green marble was found impacted in the esophagus 32 cm from the incisors. The use of forced suction allowed for the successful retrieval of the marble within minutes. The patient had an uneventful recovery without any serious complications.This NLCEC may be a viable and safe tool for the endoscopic retrieval of esophageal foreign objects without general anesthesia. This innovative design is beneficial in terms of patient safety, easy preparation, and low cost.
一名57岁男性因幻觉导致吞下一颗小弹珠而入院。随后他出现胸部不适。他有精神病史，曾患食管腐蚀性损伤并伴有食管中段狭窄。本报告描述了一种用于取出食管异物的内镜干预新方法。通过将一根30毫米无菌普通导管改装成内镜取出装置，其创新性以及对有限资源的利用，使该方法别具一格。这种新型低成本内镜帽（NLCEC）适配于内镜前端25毫米处，留出5毫米的柔软部分以防止在取出过程中损伤食管黏膜。在内镜检查时，发现一颗8毫米的绿色弹珠嵌顿在距门齿32厘米处的食管内。通过强制吸引，在数分钟内成功取出了弹珠。患者恢复顺利，未出现任何严重并发症。这种NLCEC可能是一种无需全身麻醉即可在内镜下安全取出食管异物的可行工具。这种创新设计在患者安全、易于准备和成本低廉方面具有优势。
