CC BY-NC-ND 4.0 · Endoscopy 2023; 55(S 01): E386-E387
DOI: 10.1055/a-2008-0154
E-Videos

Endoscopic removal of an appendiceal foreign body using a disposable pancreaticobiliary imaging catheter

Zhaorong Tang
Department of Gastroenterology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
,
Daixing Chen
Department of Gastroenterology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
,
Jia Deng
Department of Gastroenterology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
,
Feng Ye
Department of Gastroenterology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
,
Hong Qiu
Department of Gastroenterology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
,
Xiaolong Du
Department of Gastroenterology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
,
Xiaojun Yang
Department of Gastroenterology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
› Institutsangaben
Gefördert durch: Chongqing Municipal Health Commission & Chongqing Municipal Science and Technology Bureau 2021ZY4343

A 30-year-old man was admitted to our hospital following ingestion of a peg-like foreign body 6 days earlier. The patient reported no significant abnormalities. Physical examination showed a soft abdomen, without tenderness or rebound pain. Plain abdominal radiography revealed a peg-like object with high density in the right inferior abdomen ([Fig. 1]). Computed tomography confirmed that the object was at the appendiceal cavity, with no signs of perforation ([Fig. 2]). Endoscopic removal of the object was performed for this patient.

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Fig. 1 Plain abdominal radiograph showed a peg-like object with high density (arrow) in the right inferior abdomen.
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Fig. 2 Abdominal computed tomography showed a high-density area (arrow) at the appendiceal cavity, with no signs of perforation.

Routine colonoscopy was performed initially, but the procedure failed to find the object. Subsequently, we inserted a hydrophilic guidewire (M00556581; Boston Scientific, Marlborough, Massachusetts, USA) into the appendiceal cavity under the guidance of a sphincterotome (M00545150; Boston Scientific). Then, a disposable pancreaticobiliary imaging catheter (DPIC, D-000021494; Micro-tech [Nanjing] Co., Ltd, Nanjing, China) was inserted, and the object was identified after irrigation ([Video 1]). Finally, a spiral stone-extractor basket (CEB00000; Micro-tech [Nanjing] Co., Ltd) was used to remove the object ([Fig. 3], [Fig. 4]). After the procedure, the patient reported no discomfort, and was discharged on the same day.

Video 1 Endoscopic removal of an appendiceal foreign body using a disposable pancreaticobiliary imaging catheter.


Qualität:
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Fig. 3 The object was removed using a spiral stone-extractor basket.
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Fig. 4 The removed object.

Appendiceal foreign bodies are uncommon but may cause serious complications such as appendicitis and perforation [1] [2] [3]. The optimal method for removing appendiceal foreign bodies remains uncertain. In the present case, we used a DPIC that included a 1.8-mm working channel, charge-coupled device camera, and two dial wheels to monitor the appendiceal cavity in real time during the whole procedure. We were thus able to remove the appendiceal foreign body efficiently and safely. To the best of our knowledge, this is the first reported case of endoscopic removal of an appendiceal foreign body under visible condition. Our experience suggests that DPIC can be useful for diagnosis and treatment of appendiceal cavity diseases.

Endoscopy_UCTN_Code_TTT_1AQ_2AH

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Artikel online veröffentlicht:
03. Februar 2023

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