Glass Half Empty or Half Full: Single-Session Endoscopic Removal of Multiple Glass Vials in the Upper Gastrointestinal Tract Using a Novel Approach

Abstract

Foreign body ingestion is a commonly encountered problem clinically with management targeted at early radiological imaging to identify high-risk features that can increase the risk of perforation. We present a 23-year-old patient with no known medical or psychiatric history who presented with epigastric tenderness after ingesting multiple glass vials. The initial workup consisted of a thorough physical examination and an abdominal X-ray which revealed multiple radiopaque densities in the stomach, with some extending to the duodenum and distal colon. She underwent an emergent upper endoscopy to retrieve those glass vials given the high risk of perforation and obstruction. During the procedure, various endoscopic retrieval devices were used, however, they were unsuccessful. A novel approach was then utilized by dilating a 15-mm extraction balloon inside the lumen of the glass vials and using a snare to pull the vials out individually. Twenty-seven 6 cm × 1 cm glass vials were safely removed in a single session. The patient tolerated the procedure well and reported a complete resolution of her symptoms the next day. This case highlights the importance of obtaining prompt imaging when managing foreign body ingestion and highlights a novel endoscopic approach in safely extracting multiple glass vials that were refractory to conventional endoscopic techniques.

Keywords

• endoscopic foreign body removal
• glass vials
• extraction balloon
• snare
• ingestion of multiple foreign bodies