Endoscopic Management Of Foreign Bodies Research Articles

Esophageal Food Impaction and Foreign Object Ingestion in Gastrointestinal Tract: A Review of Clinical and Endoscopic Management

Foreign bodies in the digestive tract represent a frequent pathology for the emergency service. Foreign bodies are represented by impacted food bolus or voluntarily and involuntarily swallowed objects. Involuntary swallowing of objects occurs most frequently in children, especially between six months and three years of age. Food impaction is mostly encountered among adults with different pathologies. For the removal of swallowed foreign bodies, digestive endoscopy is the gold standard method, being successful in over 95% of cases without significant complications. For the endoscopic management of foreign bodies, it is crucial to be aware of the indications, devices, techniques and patient preparation in order to achieve successful and safe removal from the digestive tract. Recommendations in this article are based on a review of the literature and extensive personal experience.

Endoscopic management of foreign bodies and food impactions in the upper gastrointestinal tract

Giriş ve Amaç: Yabancı cisimlerin yutulmasına bağlı başvurular, gastroenterolojik aciller arasında önemli bir yer tutmaktadır. Bu çalışmadaki amacımız; üst gastrointestinal sistemde yabancı cisim veya gıda takılması nedeniyle endoskopi yapılan hastalarımızı araştırmak ve klinik tecrübelerimizi paylaşmaktır. Gereç ve Yöntem: Hitit Üniversitesi Hastanesi acil servisine Mart 2017-Mart 2020 tarihleri arasında yabancı cisimlerin yutulmasına bağlı başvurarak endoskopi yapılan olgular çalışmaya dahil edildi. Bulgular: Çalışmaya toplam 31 hasta (13 kadın, 18 erkek) dahil edildi. Endoskopik tedavi başarı oranı %96.8 (n=30/31) idi. Hastaların acil servise müracaatındaki şikayetleri yabancı cismi hissetme %87.1 disfaji %74.2, odinofaji %22.6 iken %12.9 hasta asemptomatik idi. Yabancı cismin özelliği olarak hastaların %58.1 inde künt/yumuşak cisimler ve gıda impaksiyonu izlenirken; %41.9 hastada sivri/kesici/delici cisim mevcuttu. Yerleşim yeri hastaların %83.9’unda özofagus; %12.9’unda mide; %3.2’sinde duodenum idi. Acil servise başvurularında median zaman (acile giriş kayıt saati) 14:47 idi. Acile ilk başvurudan endoskopiye kadar geçen süre 1-24 saat arası, median süre ise 3 saat idi. Endoskopik tedavi yöntemleri olarak; biyopsi forsepsi, fare dişli/timsah dişli grasperlar, snare, fileli snare, overtüp ya da endoskop yardımıyla mideye ilerletme yöntemleri kullanıldı. Sonuç: Üst gastrointestinal sistem yabancı cisimlerinde endoskopik tedavi yöntemleri etkili ve güvenlidir. Endoskopik tedavide seçilecek yöntemler; yabancı cismin tipi, yabancı cismin yeri, eşlik eden diğer faktörlere ve hastanın özelliklerine göre bireyselleştirilmelidir.

Endoscopic management of foreign bodies in the gastrointestinal tract: A retrospective study of 109 cases

Endoscopic management of foreign bodies in the gastrointestinal tract: A retrospective study of 109 cases

Endoscopic management of foreign bodies in the upper gastrointestinal tract

Background: Foreign body ingestion and food bolus impaction is a common clinical scenario and can present as an endoscopic emergency. Though majority of them pass spontaneously 10-20% require endoscopic intervention. Flexible endoscopy is recommended as therapeutic measure with minimal complications. The aim of our study is to present 5 years’ experience in dealing with foreign bodies in the upper gastrointestinal tract.Methods: Cases of foreign body ingestion admitted to department of general surgery from March 2015 to March 2020 were evaluated. The patients were reviewed with details on age, sex, type of FB, its location in gastrointestinal tract, treatment and outcome.Results: A total of 55 cases were studied. Age range was 1-85 years. Males were predominant 61.81%. Coins were found most commonly 63.6%. Esophagus was the commonest site of FB lodgement 70.9%. Upper esophagus being the most common 36.36%. Upper gastrointestinal flexible endoscopy was useful in retrieving FB in all the 55 cases. There were no complications throughout the study period.Conclusions: Flexible endoscopy should be used as definitive treatment and endoscopic treatment is safe and effective.

Endoscopic removal of foreign bodies: A retrospective study in Japan.

BACKGROUNDThe ingestion of foreign bodies (FBs) and food bolus impaction (FBI) in the digestive tract are commonly encountered clinical problems. Methods to handle such problems continue to evolve offering advantages, such as the avoidance of surgery, reduced cost, improved visualization, reduced morbidity, and high removal success rate. However, to date, no studies have evaluated the endoscopic management of FBs in Japan.AIMTo elucidate level of safety and efficacy in the endoscopic management of FBs and FBI.METHODSA total of 215 procedures were performed at Keio University Hospital between November 2007 and August 2018. Data were collected from medical charts, and endoscopic details were collected from an endoscopic reporting system. Procedures performed with a flexible gastrointestinal endoscope were only taken into account. Patients who underwent a technique involving FB or FBI from the digestive tract were only included. Data on patient sex, patient age, outpatient, inpatient, FB type, FB location, procedure time, procedure type, removal device type, success, and technical complications were reviewed and analyzed retrospectively.RESULTSAmong the 215 procedures, 136 (63.3%) were performed in old adults (≥ 60 years), 180 (83.7%) procedures were performed in outpatients. The most common type of FBs were press-through-pack (PTP) medications [72 (33.5%) cases], FBI [47 (21.9%)], Anisakis parasite (AP) [41 (19.1%) cases]. Most FBs were located in the esophagus [130 (60.5%) cases] followed by the stomach [68 (31.6%) cases]. AP was commonly found in the stomach [39 (57.4%) cases], and it was removed using biopsy forceps in 97.5% of the cases. The most common FBs according to anatomical location were PTP medications (40%) and dental prostheses (DP) (40%) in the laryngopharynx, PTP (48.5%) in the esophagus, AP (57.4%) in the stomach, DP (37.5%) in the small intestine and video capsule endoscopy device (75%) in the colon. A transparent cap with grasping forceps was the most commonly used device [82 (38.1%) cases]. The success rate of the procedure was 100%, and complication were observed in only one case (0.5%).CONCLUSIONEndoscopic management of FBs and FBI in our Hospital is extremely safe and effective.

Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract in Yaoundé (Cameroon)

Background/Aims: Foreign body (FB) ingestion is a common clinical situation. In some cases, it could be life-threatening, requiring interventional digestive endoscopy. Knowing the main FBs observed could help to prevent their ingestion or to improve management. The aim of this study is to report the results of upper digestive endoscopies performed for ingestion of FBs in Yaoundé (Cameroon). Methods: We recorded all patients who did a gastroscopy for FB ingestion from January 2000 to April 2020 in three medical centers of Yaoundé. We collected data concerning the socio-demographic characteristics of patients, foreign body type, endoscopic management and outcome. Results: A total of 9380 upper digestive endoscopies were performed, with 51 FBs ingestion (0.54%). Male were 27 (52.9%). The mean age was 25.8 ± 22.3 years (8 months to 75 years). Coins were the most frequent FB (23.5%), only observed in children, followed by fishbones (17.6%), only observed in adults. We also observed dental wears (11.8%), metallic objects (11.8%), non-metallic objects (3.9%), batteries (3.9%), toothpick (2%), packet of tablets (2%), and bezoars (2%). The FB was unknown at 21.6%. The most frequent localization was the esophagus in 29/36 patients (80.5%). Endoscopic removal was a success in 35/36 patients (97.2%). A surgery has been performed on one patient. We didn’t register any death. Conclusion: Most common FBs ingested in Yaoundé are coins and fishbones. The upper digestive endoscopy has a high success rate.

Retrospective analysis of endoscopic management of foreign bodies in the upper gastrointestinal tract of adults.

Foreign body impaction in the upper gastrointestinal (UGI) tract is considered an emergency worldwide. This article reports our experience in the endoscopic management of foreign bodies in the UGI tract of adults. A retrospective chart review was conducted on adult patients (aged >18 years) who received endoscopic management of foreign bodies in the UGI tract at Shuang Ho Hospital between November 2008 and November 2016. A total of 280 patients (male/female: 107/178; mean age: 56 years) were included. Fish bones were the most common ingested foreign bodies (n = 162; 56.8%), and the esophagus was the most common lodgment site (n = 222; 77.9%). The presence of symptoms indicated that the ingested foreign bodies were lodged in the hypopharynx or esophagus rather than in the stomach or duodenum (p < 0.01). The detection rate of ingested foreign bodies in the UGI tract through plain radiography was 53% (122/230). The average "door-to-scope" was 5.9 hours, and 99.2% of the patients received endoscopic management of the ingested foreign bodies within 24 hours. The complication rate was relatively low (n = 14; 4.9%). No patient received surgical intervention or died of endoscopic management. Endoscopic management is a safe and highly effective procedure for extracting ingested foreign bodies. Rapid endoscopic intervention should be provided to reduce the risk of complications.

Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract: Single-Centre Experience

Introduction: Foreign body ingestion is a relatively common clinical problem. We report our clinical experiences in endoscopic management of upper gastrointestinal foreign bodies by endoscopy in a centre of northern Bangladesh. Methods: This retrospective study was conducted at Shaheed Ziaur Rahman College and Hospital, Bogura, Bangladesh, over a 2-year period. Patient characteristics, endoscopic findings, type of foreign body and its anatomical location, treatments and outcomes were analyzed. Results: We included 51 patients with foreign bodies in upper gastrointestinal tract. Most of them were found in esophagus (94.12%) predominately in lower esophagus (47.92%). Dysphagia (35.29%) and foreign body sensation (27.45%) were the most common complaints of foreign bodies impaction. Meat bolus (47.06%) and coins (29.41%) were the most common type of foreign bodies in adults and children, respectively. Patients were mostly affected (21.56%) during period of Eid -al - Adha (Islamic festival of sacrifice). Endoscopic foreign body removal was successful in 98.04% of cases, whereas surgery was required in only 1 patient. The most frequently used endoscopic accessory devices were retrieval forceps (38%) and Dormia basket (38%). Associated pathology were reported in 12 (24.53%) patients. Conclusion: Our experiences with foreign bodies impaction emphasize the importance of endoscopic approach and removal is simple and safe when performed by skilled hands. So, endoscopic interventions can increase the chance of successful removal of foreign bodies and reduction of the need of surgery.

Endoscopic management of foreign bodies in the upper gastrointestinal tract: An analysis of 846 cases in China.

Foreign body ingestion is a relatively common occurrence, which may lead to morbidity and mortality. The aim of the present study was to report the experience of management of upper gastrointestinal foreign bodies by endoscopy in a large center. All patients who presented at the Department of Gastroenterology at Nanfang Hospital (Guangzhou, China) with complaints regarding upper gastrointestinal (GI) foreign body ingestion from December 1987 to December 2013. Hospital medical charts and endoscopic records were examined to evaluate etiology, treatment, and outcomes for these patients. A total of 846 patients were enrolled in the present study, from which foreign bodies were detected in 737 (87.1%) patients via X-ray or endoscopy. The objects most frequently ingested were bones (n=395, 53.6%). The detected foreign bodies were predominantly located in the cervical esophagus (n=325, 44.1%). Endoscopic foreign body extraction was successful in 92.5% of cases, whereas surgery was required in 6 patients. The most frequently used endoscopic accessory devices were retrieval forceps (n=480, 65.1%). The complication rate was 6.9%, including mucosal laceration (n=10) and others, all of which were managed conservatively. Associated GI diseases were reported in 74 (10.0%) patients, including postesophagectomy (n=34) and others. In conclusion, the endoscopic procedure was safe and effective for the removal of foreign bodies from the upper gastrointestinal tract, with a high success rate and low complication rate.

Endoscopic management of foreign bodies in the upper gastrointestinal tract

Background: Foreign body ingestion and food bolus impaction is a common clinical scenario and can present as an endoscopic emergency. Though majority of them pass spontaneously 10-20% require endoscopic intervention. Flexible endoscopy is recommended as therapeutic measure with minimal complications. The aim of our study is to present 2 years’ experience in dealing with foreign bodies in the upper gastrointestinal tract.Methods: Cases of foreign body (FB) ingestion admitted to department of general surgery from January 2015 to December 2016 were evaluated. The patients were reviewed with details on age, sex, type of FB, its location in gastrointestinal tract, treatment and outcome.Results: A total of 23 cases were studied. Age range was 2-75 years. Males were predominant (60.87%). Coins were found most commonly (52.17%). Esophagus was the commonest site of FB lodgment (65.22%). Upper esophagus being the most common (39.13%). Upper gastrointestinal flexible endoscopy was useful in retrieving FB in all the 23 cases. There were no complications throughout the study period.Conclusions: Flexible endoscopy should be used as definitive treatment and endoscopic treatment is safe and effective.

Endoscopic management of foreign bodies in the upper gastrointestinal tract: a retrospective study of 1294 cases

Objective: To report our endoscopic outcomes and explore the effects of duration of impaction and anesthetic methods on the endoscopic removal of foreign bodies in the upper gastrointestinal tract.Methods: All consecutive patients with suspected foreign body (FB) ingestion between January 2013 and June 2016 were enrolled. Demographic, clinical and endoscopic data were collected and analyzed.Results: A total of 1294 patients aged seven months to 94 years were enrolled. Odynophagia (415 cases, 32.1%), FB sensation (340 cases, 26.3%) and sore throat (267 cases, 20.1%) were the most frequent complaints. The duration of FB impaction ranged from 4 h to over two years. Anatomically, foreign bodies were most commonly located in the esophagus (n = 1025, 86.9%). Bony foreign bodies comprised the majority of identified foreign bodies. The most common underlying pathology was esophageal stricture (38 cases, 53.5%). Nearly half of the patients (49.9%) developed complications. As the duration of impaction increased, the success rate by endoscopy decreased (p < .001), and the complication rate increased (p < .001). Endoscopic management under general anesthesia didn’t improve the success rate or lower the complication rate compared with topical pharyngeal anesthesia (p = .793 and p = .085). Age ≥60, duration of impaction longer than one day, impaction in the esophagus, and sharp foreign bodies were identified as risk factors for complications.Conclusions: Delayed flexible endoscopy in patients, especially elderly patients, with sharp FB impactions in the esophagus results in worse endoscopic outcomes. Endoscopic management under general anesthesia did not improve the therapeutic results compared with topical pharyngeal anesthesia.

Endoscopic management of foreign bodies from the upper gastrointestinal tract in the hills of Himachal Pradesh, India: A 5-year tertiary care experience

Abstract Background and Aim: Foreign body (FB) ingestion is a common clinical problem in medical practice. Endoscopy is the therapeutic method of choice for the management of FBs with minimal complications. The aim of this study is to report our experience and outcome in a 5-year period in dealing with FBs in the upper gastrointestinal tract (GIT) using upper endoscopy. Materials and Methods: The records of all the patients who presented to the Department of Gastroenterology and who underwent endoscopic management between January, 2010, and December, 2014, were reviewed with details on age, sex, type of FBs and its anatomical location, treatments, and outcomes. Results: A total of 59 patients were analyzed. Their age ranged from 2 years to 87 years. A male predominance was noticed (59.4%). Coins and chicken bone shared the most commonly encountered FBs. Esophagus was the most common site of trapping (49/59). Upper endoscopy successfully resolved the problem by FB removal in all patients, thus the overall success rate was 100%. No complications or mortalities due to FB ingestion or removal were observed throughout the study. Conclusion: In our experience, endoscopic management of FBs in upper GIT is a safe and highly effective procedure.

Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract: An Evidence-Based Review Article

Gastrointestinal foreign bodies (FB) are comprised of food bolus impaction and intentionally or unintentionally ingested or inserted true FB. Food bolus impaction and true FB ingestion represent a recurrent problem and a true challenge in gastrointestinal endoscopy. More than 80–90% of the ingested true FB will pass spontaneously through the gastrointestinal tract without complications. However, in 10–20% of the cases an endoscopic intervention is deemed necessary. True FB ingestion has its greatest incidence in children, psychiatric patients and prisoners. On the other hand, food bolus impaction typically occurs in the elderly population with an underlying esophageal pathology. The most serious situations, with higher rates of complications, are associated with prolonged esophageal impaction, ingestion of sharp and long objects, button batteries and magnets. Physicians should recognize early alarm symptoms, such as complete dysphagia, distressed patients not able to manage secretions, or clinical signs of perforation. Although many papers are yearly published regarding this subject, our knowledge is mainly based on case-reports and retrospective series. Herein, the authors summarize the existing evidence and propose an algorithm for the best approach to FB ingestion.

Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract of Adults.

Background. Foreign object ingestion and food bolus impaction are a common clinical problem. We report our clinical experiences in endoscopic management for adults, foreign body ingestion, and food bolus impaction. Method. A retrospective chart review study was conducted on adult patients with foreign body ingestion and food bolus impaction between January 2011 and November 2014. Patients with incomplete medical records were excluded. Results. A total of 198 patients (226 incidents) were included in the study (male/female: 1.54/1; age 57 ± 16 years). Among them, 168 foreign bodies were found successfully (74.3%). 75.6% of the foreign bodies were located in the esophagus. Food bolus impaction was most common (41.6%). 93.5% of foreign bodies in current study cohort were successfully extracted and 5 patients required surgical interventions. Comparisons between symptomatic and asymptomatic patients revealed that locations of foreign bodies in the pharynx and esophagus were the significant relevant factors (P < 0.001). Shorter time taken to initiate endoscopic interventions increased detection rate (289.75 ± 465.94 versus 471.06 ± 659.93 minutes, P = 0.028). Conclusion. Endoscopic management is a safe and highly effective procedure in extracting foreign body ingestion and food bolus impaction. Prompt endoscopic interventions can increase the chance of successful foreign bodies' detection.

Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract: An Analysis of 846 Cases in China

Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract: An Analysis of 846 Cases in China

Endoscopic management of foreign bodies in the upper gastrointestinal tract: A review.

Foreign body ingestion is a common condition, especially among children who represent 80% of these emergencies. The most frequently ingested foreign bodies in children are coins, toys, magnets and batteries. Most foreign body ingestions in adults occur while eating, leading to either bone or meat bolus impaction. Flexible endoscopy is the therapeutic method of choice for relieving food impaction and removing true foreign bodies with a success rate of over 95% and with minimal complications. This review describes a comprehensive approach towards patients presenting with foreign body ingestion. Recommendations are based on a review of the literature and extensive personal experience.

Transparent cap‐assisted endoscopic management of foreign bodies in the upper esophagus: A randomized, controlled trial

Ingestion of foreign bodies (FBs) in the upper esophagus is common in South China. It is difficult to manage because of limited working space and inadequate visual field in this area. This randomized, controlled study aimed to evaluate the usefulness of a transparent cap in the endoscopic management of FBs in the upper esophagus. Adult patients suspected of FBs in the upper esophagus based on the history of FBs ingestion, symptoms, and barium contrast examination were screened for the study between March 1, 2009 and December 31, 2010. Seventy patients with endoscopic-confirmed FBs in the upper esophagus were recruited and were randomly assigned to two groups: transparent cap-assisted esophagogastroduodenoscopy group (n = 35) or conventional esophagogastroduodenoscopy group (n = 35). The type, size, and location of FBs, the operation time for removing the FBs, and the clearness of visual field were compared between these two groups. The type, size, and location of FBs were similar between the two groups (P > 0.05). The average operation time for removing the FBs was significantly shorter in the transparent cap-assisted group than in the conventional group (2.6 min vs 4.1 min, P = 0.008). Visual field was rated as "clear" in more cases in the transparent cap-assisted group than in the conventional group (97.1% vs 25.7%, P < 0.0001). Transparent cap-assisted endoscopy was a safe and effective method in the management of FBs in the upper esophagus, with a shorter operation time and clearer visual field.

Endoscopic Management of Foreign Bodies in the Gastrointestinal Tract

The majority of foreign body (FB) ingestions occur in children. In adults, accidental FB ingestion tends to be food (meat) bolus. Non-food FB ingestions occur more in denture users, incarcerated individuals, and patients with psychiatric disorders or alcohol intoxication. The majority of the ingested FBs will pass spontaneously. Once through the esophagus, most FBs including sharp objects pass uneventfully. Sharp or pointed FBs, animal or fish bones, and magnets increase the risk of perforation. Emergent endoscopy is indicated in: (1) esophageal obstruction when the patient is unable to swallow secretions and (2) disk batteries and sharp-pointed FBs in the esophagus. In general, esophageal FBs and food impactions without complete obstruction should be removed within 24 h (urgent endoscopy). This video manuscript describes general principles, devices, and techniques in endoscopic management of ingested FBs. Several clinical scenarios are presented. This article is part of an expert video encyclopedia.

Upper Gastro-Intestinal Foreign Bodies: Etiology and Patient Characteristics Based on a Single Center Experience

Purpose: To retrospectively analyze our experience in patients with upper gastro-intestinal tract (UGIT) foreign bodies (FB). Methods: A list was generated from our endoscopy database of all the patients who had undergone esophagogastroduodenoscopy (EGD) between 01/01/2006 and 10/31/2009 for a presumed diagnosis of FB in the UGIT. Data were collected for demographics, clinical presentation, underlying medical history, EGD findings, and type of FB. Patients were grouped based on the age at the time of EGD: pediatric (0-21 years) and adult (>21 years). Adults were further sub-divided into 2 groups based on the type of FB: acute food bolus obstruction (AFBO) and unusual/sharp objects (USO). Results: Demographics: A total of 73 endoscopic procedures were performed in 61 patients; 44 (72.1%) were males. Mean age was 39.3 (range: 1-92 years). There were 17 (28%) pediatric subjects, 26 (42.6%) adults with AFBO and 18 (29.4%) adults with USO; this latter group had 30 presentations. Pediatric Patients with FB: Mean age was 5.6 (range 1-16 yrs). Coins comprised the majority (80%) in younger children (0-5 years) and 28% in the older children (6-21 years). Other FB included batteries, beer bottle cap, pin, and fruit seed. There was one EGD failure due to impacted FB at the crico-pharyngeus; this was succesfully removed in the operating room by an ENT surgeon. Patients with AFBO: Mean age was 56 (range 22-92 yrs). Esophageal biopsies were obtained in 12 (46.1%) patients. Biopsy rates for the years 2006-2007 and 2008-2009 were 5/14 (35.7%) and 7/9 (77.7%), respectively. Esophageal pathology was found in 14 (53.8%) cases, as shown in the table. Of note, all 3 patients (11.5%) with eosinophilic esophagitis (EoE), were adult males under the age of 40. There were no EGD failures or complications. Patients with USO: Mean age was 47 (range 27-69 yrs). Underlying mental disorder was present in 8/18 (44.4%) and in all 5 patients (27.7%) with recurrent USO ingestion. Protective measures were used in two instances for the removal of a razor blade (hood) and chicken bone (intubation). There were no EGD failures or complications. Conclusion: The most common FB was AFBO in adults and coins in children. Underlying esophageal pathology is often seen in adult patients with AFBO. USO ingestion and repeated presentations are more common in patients with underlying mental disorders. Endoscopic management of FB in UGIT is safe and highly successful.Table: Underlying esophageal pathology found on EGD in AFBO group

Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract in South China: A Retrospective Study of 561 Cases

Ingestion of a foreign body (FB) is a common occurrence; however, few studies have reported its characteristics and endoscopic management in South China. The aim of this study is to investigate the clinical features of FB ingestion in South China and report its management through endoscopy. Data were collected from all consecutive patients with suspected FB ingestion accepting endoscopic management in our endoscopy center during the past 10 years. The demographic data, clinical presentations, and endoscopic management were reviewed and analyzed retrospectively. A total of 561 patients with suspected FB ingestion underwent endoscopic management. Among them, 447 FBs were found in 439 (78.3%) patients. Fish bone ingestion was most common (60.4%). Most of the FBs were located in the esophagus (84.5%). The majority of patients (96.1%) were successfully treated with flexible endoscopy with the addition of suitable devices without any serious procedure-related complications. There was a significant difference in the types of FBs between the former and latter 5 years (P < 0.05), and fish bone ingestion became more prevalent with time. Compared with the conventional methods, a new technique with a reworked transparent cap was successful in dealing with small sharp FBs impacted at the entrance of esophagus. The new technique had a shorter operation time (11.7 versus 17.9 min, P = 0.02) and an increased success rate (by 8%). In South China, fish bone is the most common FB found in the upper gastrointestinal tract. Endoscopic management is a safe and effective approach in managing FBs. A new technique with reworked transparent cap is useful and promising, but further study is needed for confirmation.