International Journal of General Medicine (Dec 2021)

Endoscopic Removal of Sharp-Pointed Foreign Bodies with Both Sides Embedded into the Duodenal Wall in Adults: A Retrospective Cohort Study

  • Yu M,
  • Li K,
  • Zhou S,
  • Wang H,
  • Le M,
  • Li C,
  • Liu D,
  • Tan Y

Journal volume & issue
Vol. Volume 14
pp. 9361 – 9369

Abstract

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Meihong Yu,1,2 Kaixuan Li,3 Shishuang Zhou,4 Hanyu Wang,1,2 Meixian Le,1,2 Chen Li,1,2 Deliang Liu,1,2 Yuyong Tan1,2 1Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People’s Republic of China; 2Research Center of Digestive Disease, Central South University, Changsha, Hunan, 410011, People’s Republic of China; 3Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China; 4Department of Nursing Administration, Army Military Medical University, Chongqing, 400038, People’s Republic of ChinaCorrespondence: Yuyong TanDepartment of Gastroenterology, The Second Xiangya Hospital, Central South University, No. 139 Middle Renmin Road, Changsha, Hunan, 410011, People’s Republic of ChinaTel +86-15116280621Fax +86-731-85533525Email [email protected] LiDepartment of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of ChinaTel +86 15580027242Email [email protected]: Sharp-pointed FBs with both sides embedded in the duodenal wall are rare. Compared with smooth edged FBs, sharp objects are more likely to be associated with significant adverse events, when penetrating the wall of the digestive tract. The clinical features of patients who experienced sharp-pointed FBs embedded in both sides of the duodenum were retrospectively analyzed, as were the efficacy and safety of endoscopic removal of these FBs.Patients and Methods: This retrospective study included 21 adults with both sides of sharp-pointed FBs embedded into the duodenal wall who were admitted to the Second Xiangya Hospital in China between January 1, 1996, and May 31, 2021. Data associated with the endoscopic removal of these FBs were collected from the electronic medical record system (EMRS) of the hospital.Results: The incidence rate of duodenal total FBs and FBs embedded in both sides was 8.87% and 1.03%, respectively. The success rate of endoscopic treatment was 100.00% in 124 patients without embedded duodenal FBs and 97.14% in 35 patients with one side embedded duodenal FBs. Of the 21 patients with FBs embedded in both sides of the duodenal wall, endoscopic removal was successful in 85.71% of patients, whereas 14.29% required surgery. FBs removed from these patients included toothpicks in 12; needles in 3; jujube pits in 2; and a chopstick, dentures, fish bones, and chicken bones in one each. Most of these 21 FBs were located in the bulb and descending duodenum, followed by the third part of duodenum.Conclusion: Sharp-edged FBs with both sides embedded in the duodenal wall are rare. Endoscopic removal may be considered as a feasible, safe, and effective method of removing sharp-pointed FBs with both sides embedded in the duodenal wall. And if endoscopic removal is unsuccessful, surgical management can be a secondary option.Keywords: adult, duodenum, endoscopic removal, foreign bodies, surgical operation

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