Clin Endosc.  2015 Sep;48(5):444-446. 10.5946/ce.2015.48.5.444.

Successful Removal of a Screw Nail in the Jejunum Using Double-Balloon Enteroscopy

Affiliations
  • 1Department of Internal Medicine, Sahmyook Medical Center, Seoul, Korea.
  • 2Department of Internal Medicine, Seongbuk Joongang Hospital, Seoul, Korea.
  • 3Institute for Digestive Research, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea. iman0825@schmc.ac.kr

Abstract

The vast majority of foreign bodies (FBs) that enter the stomach pass through the gastrointestinal tract spontaneously. When the FB enters the small bowel-beyond the reach of conventional endoscopy-daily radiographs are needed to ensure its safe passage. However, endoscopic intervention is an appropriate management strategy for a sharp-pointed FB, because sharp FBs have a higher risk of intestinal perforation. We describe here a case in which a 1.5-cm, sharp-pointed screw nail in the proximal jejunum was removed successfully by double-balloon enteroscopy from a 19-year-old-male with autism. This case adds to the growing body of evidence demonstrating the value of therapeutic double-balloon enteroscopy in the field of FB ingestion

Keyword

Double-balloon enteroscopy; Endoscopic removal of sharp objects; Foreign bodies; Jejunum; Screw nail

MeSH Terms

Autistic Disorder
Double-Balloon Enteroscopy*
Eating
Foreign Bodies
Gastrointestinal Tract
Intestinal Perforation
Jejunum*
Stomach

Figure

  • Fig. 1 Radiologic findings for an ingested sharp, pointed screw nail. (A) Abdominal simple radiography detected the presence of a sharp, pointed screw nail. (B) Abdominal computed tomography revealed a sharp, pointed screw nail in the proximal jejunum without evidence of small bowel perforation.

  • Fig. 2 Double-balloon enteroscopic findings of the ingested foreign body. (A) Double-balloon enteroscopy revealed a screw nail in the proximal jejunum without endoscopic evidence of perforation. (B) Endoscopic removal of the screw nail was attempted using a polypectomy snare. The screw nail in the jejunum was retrieved using a polypectomy snare.


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