[Catch me if you can: endoscopic remove of a needle from the jejunum].
BACKGROUND
The ingestion of foreign bodies is a frequently observed problem in daily clinical practice. In order to avoid complications such as perforation, endoscopic removal of potentially penetrating foreign bodies should be attempted quickly. The use of various endoscopic techniques has been reported for this purpose. However, extraction of foreign bodies from the mid gastrointestinal tract has rarely been reported.


METHODS
We present the case of a patient who had swallowed a safety needle which could safely be removed from the jejunum by means of double-balloon enteroscopy (DBE). The combination of a thin p-type enteroscope with a thick t-type overtube was used in order to improve the manoeuvrability of the endoscope. The needle was pulled into the overtube which served as a protective shield during the retrieval of the endoscope.


CONCLUSIONS
Our case report describes the potential of removing foreign bodies from the deep small bowel by pulling them into the overtube of a double-balloon enteroscope. If the suspicion of foreign body impaction in the small bowel is made, it may be advisable to primarily choose a balloon enteroscopy system. Through this, quick and deep insertion can be combined with a safe removal of the foreign body.
Zentrum für Innere Medizin II, Dr. Horst-Schmidt-Kliniken, Wiesbaden.
J W
JW
Rey
Klinik für Hals-Nasen-Ohrenheilkunde, Dr. Horst-Schmidt-Kliniken, Wiesbaden.
J
J
Gosepath
Zentrum für Innere Medizin II, Dr. Horst-Schmidt-Kliniken, Wiesbaden.
A
A
Hoffman
Zentrum für Innere Medizin II, Dr. Horst-Schmidt-Kliniken, Wiesbaden.
R
R
Kiesslich
Zentrum für Innere Medizin II, Dr. Horst-Schmidt-Kliniken, Wiesbaden.
H
H
Manner
D000368:Aged; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005548:Foreign-Body Migration / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007583:Jejunum / Q000293:injuries* / Q000473:pathology / Q000601:surgery*; D016602:Needlestick Injuries / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome