Kim Jeongseok, Lee Beom Jae, Ham Nam Seok, Oh Eun Hye, Choi Kee Don, Ye Byong Duk, Byeon Jeong-Sik, Eun Chang Soo, Kim Jin Su, Yang Dong-Hoon
Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea.
Gastroenterol Res Pract. 2020 May 19;2020:3814267. doi: 10.1155/2020/3814267. eCollection 2020.
Balloon-assisted enteroscopy (BAE) can be used to retrieve small intestinal foreign bodies (FBs). Here, we aimed at exploring the clinical usefulness of BAE for the retrieval of small intestinal FBs.
We retrospectively reviewed the medical records of 34 patients who underwent BAE to retrieve small intestinal FBs at 3 tertiary referral centers between April 2005 and June 2017.
The retained materials included capsule endoscopes (CEs; = 18 [52.9%]), self-expandable metal stents (SEMSs; = 5 [14.7%]), biliary drainage catheters ( = 4 [11.8%]), gallstones ( = 3 [8.8%]), an embolization coil (2.9%), a needle, an intragastric bariatric balloon, and a razor blade. FBs were located or stuck in the ileum ( = 17 [50%]), jejunum ( = 16 [47.1%]), and an undetermined small intestinal segment ( = 1). Seventeen cases of FBs (50%; 7 CEs, 3 biliary drainage catheters, 3 SEMSs, 2 gallstones, 1 intragastric balloon, and 1 needle) were successfully retrieved enteroscopically. FBs of 4 asymptomatic patients (3 CEs and 1 razor blade) passed spontaneously. The remaining 13 patients underwent surgery for persistent or symptomatic FBs: 12 were successfully removed and 1 CE removal procedure failed due to severe peritoneal adhesions. The presence of symptoms was the only independent predictor of successful retrieval using BAE (odds ratio 13.40, 95% confidence interval 1.10-162.56, = 0.042). BAE-related complications such as bowel perforation and acute pancreatitis occurred in 2 patients (5.9%).
BAE can be the first option for FB removal in the small intestine. The presence of symptoms was associated with successful enteroscopic retrieval.
气囊辅助小肠镜检查（BAE）可用于取出小肠异物（FBs）。在此，我们旨在探讨BAE在取出小肠FBs方面的临床实用性。
我们回顾性分析了2005年4月至2017年6月期间在3家三级转诊中心接受BAE取出小肠FBs的34例患者的病历。
留存的物品包括胶囊内镜（CEs；n = 18 [52.9%]）、自膨式金属支架（SEMSs；n = 5 [14.7%]）、胆道引流导管（n = 4 [11.8%]）、胆结石（n = 3 [8.8%]）、一个栓塞线圈（2.9%）、一根针、一个胃内减肥气囊和一片剃须刀片。FBs位于或卡在回肠（n = 17 [50%]）、空肠（n = 16 [47.1%]）和一段未确定的小肠段（n = 1）。17例FBs（50%；7例CEs、3例胆道引流导管、3例SEMSs、2例胆结石、1例胃内气囊和1例针）通过小肠镜成功取出。4例无症状患者的FBs（3例CEs和1片剃须刀片）自行排出。其余13例患者因FBs持续存在或出现症状而接受手术：12例成功取出，1例CE取出手术因严重的腹膜粘连而失败。症状的出现是使用BAE成功取出的唯一独立预测因素（比值比13.40，95%置信区间1.10 - 162.56，P = 0.042）。2例患者（5.9%）发生了与BAE相关的并发症，如肠穿孔和急性胰腺炎。
BAE可作为小肠FBs取出的首选方法。症状的出现与小肠镜成功取出相关。
