title: Double balloon enteroscopy is a safe and effective procedure in removing entrapped foreign objects in the small bowel for up to 3 months.
abstract: Recent case series have shown that enteroscopy is safe and effective to remove entrapped small bowel foreign bodies. However, the optimal timing for the foreign body retrieval in terms of duration of entrapment and when to consider surgical intervention are unknown. In this case series, we report that antegrade and retrograde enteroscopy can be used safely to retrieve foreign bodies entrapped in the small bowel for longer than 70 days. In total, 20 patients (mean age, 48 years; 11 females) with entrapped foreign bodies in the small intestine underwent antegrade, retrograde, or combined double balloon enteroscopy for retrieval of objects. Symptoms prompted removal of entrapped, nonsharp objects in all patients and included abdominal pain, nausea, and vomiting. The mean time of entrapment was 83 days (range, 4-272 days). There were 15 cases of retained video capsule endoscopy (VCE) with a mean entrapment time of 106 days (range, 7-272 days). Two VCEs could not be removed safely with enteroscopy. Other retained small bowel objects included in this study were nails and fish hooks. Their average entrapment time was 13 days (range, 4-43 days). Of the 30 enteroscopies, there was only 1 case (3%) with a complication (perforation). According to this case series, experienced endoscopists can safely and effectively retrieve foreign bodies in the small bowel, particularly VCE, that are retained for extended periods of time.
authors.affiliation: 1 Department of Gastroenterology and Hepatology, Mayo Clinic , Jacksonville, Florida.
authors.forename: Wei-Chung
authors.initials: WC
authors.lastname: Chen
authors.forename: Michael
authors.initials: M
authors.lastname: Bartel
authors.forename: Thomas
authors.initials: T
authors.lastname: Kroner
authors.forename: John A
authors.initials: JA
authors.lastname: Stauffer
authors.forename: Mark E
authors.initials: ME
authors.lastname: Stark
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Lukens
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D053705:Capsule Endoscopes; D058582:Double-Balloon Enteroscopy / Q000009:adverse effects / Q000379:methods; D005260:Female; D005547:Foreign Bodies / Q000150:complications / Q000628:therapy*; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology; D007421:Intestine, Small; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D013997:Time Factors; D014839:Vomiting / Q000209:etiology; D055815:Young Adult