Abstract
Background and Aims Balloon-assisted enteroscopy (BAE) can be used to retrieve small intestinal foreign bodies (FBs). Here, we aimed at exploring the clinical usefulness of BAE for the retrieval of small intestinal FBs. Methods We retrospectively reviewed the medical records of 34 patients who underwent BAE to retrieve small intestinal FBs at 3 tertiary referral centers between April 2005 and June 2017. Results The retained materials included capsule endoscopes (CEs; n = 18 [52.9%]), self-expandable metal stents (SEMSs; n = 5 [14.7%]), biliary drainage catheters (n = 4 [11.8%]), gallstones (n = 3 [8.8%]), an embolization coil (2.9%), a needle, an intragastric bariatric balloon, and a razor blade. FBs were located or stuck in the ileum (n = 17 [50%]), jejunum (n = 16 [47.1%]), and an undetermined small intestinal segment (n = 1). Seventeen cases of FBs (50%; 7 CEs, 3 biliary drainage catheters, 3 SEMSs, 2 gallstones, 1 intragastric balloon, and 1 needle) were successfully retrieved enteroscopically. FBs of 4 asymptomatic patients (3 CEs and 1 razor blade) passed spontaneously. The remaining 13 patients underwent surgery for persistent or symptomatic FBs: 12 were successfully removed and 1 CE removal procedure failed due to severe peritoneal adhesions. The presence of symptoms was the only independent predictor of successful retrieval using BAE (odds ratio 13.40, 95% confidence interval 1.10–162.56, P = 0.042). BAE-related complications such as bowel perforation and acute pancreatitis occurred in 2 patients (5.9%). Conclusions BAE can be the first option for FB removal in the small intestine. The presence of symptoms was associated with successful enteroscopic retrieval.
Highlights
The retention of foreign bodies (FBs) in the small intestine can occur after their ingestion by patients who have a normal small intestine or an underlying intestinal pathology such as stricture, adhesion, mass, or diverticulum [1]
Since the introduction of balloon-assisted enteroscopy (BAE) including double-balloon enteroscopy (DBE) and single-balloon enteroscopy (SBE), surgery is occasionally used for FB retrieval from the small intestine [2,3,4,5,6,7,8]
We reviewed the medical records of patients who underwent BAE for the retrieval of small intestinal FBs at 3 tertiary referral centers between April 2005 and June 2017
Summary
The retention of foreign bodies (FBs) in the small intestine can occur after their ingestion by patients who have a normal small intestine or an underlying intestinal pathology such as stricture, adhesion, mass, or diverticulum [1]. Surgical treatment was historically the first option for FB retrieval when patients presented with symptoms related to complications such as intestinal obstruction, perforation, and bleeding [2]. Balloon-assisted enteroscopy (BAE) can be used to retrieve small intestinal foreign bodies (FBs). The retained materials included capsule endoscopes (CEs; n = 18 [52.9%]), self-expandable metal stents (SEMSs; n = 5 [14.7%]), biliary drainage catheters (n = 4 [11.8%]), gallstones (n = 3 [8.8%]), an embolization coil (2.9%), a needle, an intragastric bariatric balloon, and a razor blade. Seventeen cases of FBs (50%; 7 CEs, 3 biliary drainage catheters, 3 SEMSs, 2 gallstones, 1 intragastric balloon, and 1 needle) were successfully retrieved enteroscopically. The remaining 13 patients underwent surgery for persistent or symptomatic FBs: 12 were successfully removed and 1 CE removal procedure failed due to severe peritoneal adhesions. The presence of symptoms was associated with successful enteroscopic retrieval
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