Endoscopy 2022; 54(05): E178-E179
DOI: 10.1055/a-1463-1971
E-Videos

Hanging on by a thread: gastric extraction of ingested tampons

Kirill Basiliya
Department of Gastroenterology and Hepatology, Jeroen Bosch Hospital, ʼs-Hertogenbosch, The Netherlands
,
Henk-Marijn de Jonge
Department of Gastroenterology and Hepatology, Jeroen Bosch Hospital, ʼs-Hertogenbosch, The Netherlands
,
Koen van Hee
Department of Gastroenterology and Hepatology, Jeroen Bosch Hospital, ʼs-Hertogenbosch, The Netherlands
› Author Affiliations

A 24-year-old patient with a history of psychiatric co-morbidity presented after auto-ingestion of tampons and batteries. Both had been ingested on several occasions in the preceding 24 hours, and the patient declined to specify an exact number of ingested foreign bodies.

While we were able to easily extract the batteries with a snare, the extraction of the tampons presented a challenge. A single guideline [1] mentions tampon ingestion, but does not elaborate the endoscopic technique required for effective extraction. The tampons were swollen with gastric secretions and were too wide to be passed through an overtube, while a Roth net basket was too small to fully grasp the tampon. A snare provided excellent grip when grasping the tampon in its middle, but this transverse alignment of the tampon made it too wide to pass through the gastroesophageal junction (GEJ). The use of a snare or Rockstar basket to grasp the side of a tampon provided insufficient grip to pull the tampon across the GEJ. Finally, capture of the tampon cord allowed both an effective grip and the necessary longitudinal alignment with the GEJ for successful extraction ([Fig. 1]; [Video 1]), and allowed the extraction of 15 tampons, along with seven batteries ([Fig. 2]).

Zoom Image
Fig. 1 Endoscopic view showing a tampon being extracted by grasping its cord.

Video 1 Gastric extraction of multiple ingested tampons.


Quality:
Zoom Image
Fig. 2 Photograph of the extracted foreign bodies.

To the best of our knowledge, this is the first report describing gastric extraction of ingested tampons, and we believe that the method presented here provides an effective way of extracting such challenging objects from the upper gastrointestinal tract.

Endoscopy_UCTN_Code_TTT_1AO_2AL

Endoscopy E-Videos
https://eref.thieme.de/e-videos

Endoscopy E-Videos is an open access online section, reporting on interesting cases and new techniques in gastroenterological endoscopy. All papers include a high quality video and all contributions are freely accessible online. Processing charges apply (currently EUR 375), discounts and wavers acc. to HINARI are available.

This section has its own submission
website at
https://mc.manuscriptcentral.com/e-videos



Publication History

Publication Date:
28 April 2021 (online)

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany