[Difficult endoscopic extraction: pneumomediastinum and bilateral pneumothorax after attempted endoscopic extraction of needle incarcerated in hiatal hernia].
From June 1987 to April 2000, 167 (74%) of 223 patients suspected of swallowing foreign bodies were treated. Hundred-sixty-three were successfully treated endoscopically. The surgery rate was 2.4%. There was failure to remove a tablespoon, a tooth-brush, a dental prostheses with metallic hook, a knitting-needle. The sharp and pointed foreign bodies were 35 (20.9%). Endoscopic removal of sharp and pointed foreign bodies in the upper gastrointestinal tract can be very difficult to manage. The Authors report iatrogenic perforation of esophagus-gastric-fundus in a patient with hiatus hernia who ingested a big knitting-needle in order to suicide. They think that it is absolutely necessary to use special endoscopic equipment during the taking out of foreign-body procedure, especially when pointed and sharp-edge shaped bodies are involved and when there is high risk of iatrogenic lesions.
Scamporrino
A
A
Istituto di Clinica Chirurgica d'Urgenza e di Pronto Soccorso, Università degli Studi La Sapienza Roma.
Mongardini
M
M
Stagnitti
F
F
Corona
F
F
Costantini
A
A
Priore
F M
FM
Tiberi
R
R
Iannetti
A
A
Occhigrossi
G
G
D000328:Adult; D004945:Esophagoscopy; D004947:Esophagus; D005260:Female; D005547:Foreign Bodies / Q000150:complications* / Q000601:surgery*; D006551:Hernia, Hiatal / Q000150:complications*; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D008478:Mediastinal Emphysema / Q000209:etiology*; D009339:Needles; D011030:Pneumothorax / Q000209:etiology*; D013406:Suicide, Attempted