フード付き内視鏡によるPTP食道異物の除去

Abstract

We report a case in which a press-through-package (PTP) foreign body in the esophagus was safely removed by hooded endoscopy. A 63-year-old male patient presented with a complaint of retrosternal discomfort after ingesting a tablet in a PTP. Soft X-ray films of the spine showed the PTP foreign body in front of the sixth cervical vertebra. During endoscopic examination, the PTP foreign body was detected in the esophagus about 30 cm from the mouth. Hooded endoscopy using part of a disposable latex glove was performed. Initially, the PTP foreign body was grasped with a retrieval forceps. After that, the PTP foreign body was covered with the hooded part of the endoscope. Then the hooded endoscope was slowly pulled out together with the PTP foreign body. After extraction of the PTP foreign body, another endoscopic examination revealed slight mucosal injuries in the esophagus. The PTP foreign body was able to be extracted quickly without any complications. The extracted PTP foreign body was 2.4×2.0 cm in size. The method used in this case is a safe and effective means of removing foreign bodies using readily available instruments. Its major advantage is the use of a hood to prevent injury to the pharyngoesophageal junction. Hooded endoscopies should be more commonly used for foreign body extractions because they can be performed easily without special apparatus.