Luo Qi, Tang Lin, Ye Lian-Song, Jiang Zhi-Jie, Mou Yi, Hu Bing
Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
Department of Emergency Medicine, West China School of Nursing, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
World J Gastrointest Endosc. 2025 Feb 16;17(2):102501. doi: 10.4253/wjge.v17.i2.102501.
Sharp foreign body ingestion can cause gastrointestinal tract mucosa injury and requires proper endoscopic removal. Typically, protective devices are used to reduce mucosal damage. This case presents an alternative approach for the endoscopic removal of a large, irregular, and sharp foreign body (chicken bone) when traditional protective devices are inadequate, thus contributing to the management of such ingestions.
A 57-year-old male presented with a history of swallowing an irregular and sharp-pointed chicken bone. Emergent endoscopy showed it was tightly embedded in the esophageal wall, with minor bleeding. The chicken bone was grasped and moved cautiously using a foreign forceps. It was loosened after repeated attempts but could not pass through the pharynx. Considering possible mucosal damage, it was carefully pushed into the stomach cavity and then wrapped in a condom. The chicken bone was retrieved uneventfully by grasping the open edge of the condom with foreign forceps. No additional damage was found, except for primary esophageal injuries caused by the embedded chicken bone. The patient was discharged on the following day. Our experience demonstrated that condoms can be an alternative as a protective device under such conditions.
Condoms can serve as an alternative when traditional protective devices are unsuitable. Because of its smooth and oily nature, it can provide mucosal protection and lubrication during endoscopic removal.
尖锐异物摄入可导致胃肠道黏膜损伤,需要通过适当的内镜取出。通常,会使用保护装置来减少黏膜损伤。本病例介绍了一种在内镜下取出大的、不规则的尖锐异物(鸡骨)的替代方法,当传统保护装置不适用时,此方法有助于此类异物摄入的处理。
一名57岁男性,有吞咽不规则尖锐鸡骨的病史。急诊内镜检查显示鸡骨紧密嵌顿于食管壁,有少量出血。使用异物钳小心地抓取并移动鸡骨。经多次尝试后鸡骨松动,但无法通过咽部。考虑到可能造成黏膜损伤,遂小心地将其推入胃腔,然后用避孕套包裹。用异物钳抓住避孕套开口边缘,顺利取出鸡骨。除了鸡骨嵌顿造成的原发性食管损伤外,未发现其他额外损伤。患者于次日出院。我们的经验表明,在这种情况下,避孕套可作为一种替代保护装置。
当传统保护装置不适用时,避孕套可作为一种替代选择。由于其光滑且有油性,在内镜取出过程中可提供黏膜保护和润滑作用。