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Case Reports
. 2006 Sep 28;12(36):5909-12.
doi: 10.3748/wjg.v12.i36.5909.

Removal of press-through-packs impacted in the upper esophagus using an overtube

Yeon-Seok Seo  1 , Jong-Jae Park, Ji-Hoon Kim, Jin-Yong Kim, Jong-Eun Yeon, Jae-Seon Kim, Kwan-Soo Byun, Young-Tae Bak
Affiliations
Case Reports

Removal of press-through-packs impacted in the upper esophagus using an overtube

Yeon-Seok Seo et al. World J Gastroenterol. .

Abstract

Foreign bodies in the upper esophagus should be removed as soon as possible to avoid serious complications. However, removals of foreign bodies in the upper esophagus are very difficult, especially if they have sharp edges, such as press-through-packs (PTPs). We experienced four cases of the impacted PTPs in the upper esophagus which was successfully extracted endoscopically with the overtube. Because two edges of PTPs were so firmly impacted in the esophageal wall in all cases, the PTPs were not movable in the upper esophagus. However, after insertion of the overtube, PTPs became movable and were successfully extracted and no serious complications occurred after extraction of PTPs. In one case, insertion of the overtube rapidly expanded the upper esophagus and PTP progressed to the gastric cavity and it could be extracted with the endoscopic protector hood. The endoscopic removal with the overtube was a simple, safe and effective technique for the removal of the impacted PTPs in upper esophagus.

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Figures

Figure 1
Figure 1
Endoscopic image showing a press-through-pack impacted in the upper esophageal wall.
Figure 2
Figure 2
Method for removal of a press-through-pack impacted in the upper esophagus. A: The press-through-pack was located using a diagnostic endoscope; B: an overtube was inserted and resulted in relaxation of the upper esophagus, which enabled the impacted press-through-pack to be moved; C: forceful pulling of the press-through-pack using forceps caused the edges of the PTP to bend, enabling it to enter the overtube.
Figure 3
Figure 3
Endoscopic image showing distal relocation of a press-through-pack that was previously impacted and immovable. Erosions proximal to the press-through-pack indicate the site at which the press-through-pack was impacted until insertion of the overtube.
Figure 4
Figure 4
A: Endoscopic image showing forceful retraction of the press-through-pack by a forceps; B shows how the edges of the press-through-pack were bent (arrow) during entry into the overtube.
See this image and copyright information in PMC

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