Endoscopic removal of sharp foreign bodies impacted in the esophagus

Background and Study Aims: Impacted sharp foreign bodies in the esophagus c an be very difficult to manage. When attempts are made to remove such objec ts inappropriately, life-threatening complications such as perforation can occur. The aim of this study was to evaluate the safety and efficacy of end oscopic removal of impacted sharp foreign bodies in the esophagus using pro ximal dilatation with an oral side balloon or transparent cap. Patients and Methods: A total of 22 patients (10 men, 12 women) with impact ed sharp foreign bodies in the esophagus underwent endoscopic extraction. T he following technique was successfully performed at our hospital. An oral side balloon (Top Co., Japan) for esophageal variceal sclerotherapy was att ached to the distal part of the endoscope, With the patient under local ane sthesia, the endoscope was inserted as far as the proximal part of the esop hageal foreign body. The oral side balloon was then gradually inflated. Dil atation of the proximal part of the esophagus made it possible to release t he impacted sharp foreign body from the esophageal wail. A transparent cap was used for foreign bodies in the upper esophagus when there were difficul ties with the oral side baboon, Results: The types of foreign body removed were fish bones (n = 9), press-t hrough packages (n = 8), chicken bones (n = 3), dentures (n = 1), and a wri st watch (n = I). Endoscopic removal was successful in all but one of the c ases, in which a fish bone had to be extracted surgically. Conclusions: The proximal dilatation method using an oral side balloon or t ransparent cap is safe and effective in removing sharp foreign bodies from the esophagus, avoiding surgery and possible perforation.