Case Report
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Sep 16, 2014; 6(9): 453-456
Published online Sep 16, 2014. doi: 10.4253/wjge.v6.i9.453
Endoscopic retrieval of an 18-cm long chopstick embedded for ten months post-automutilation in the esophagus of a patient with psychosis
Sheng-Xi Li, Hui Li, Tao Chen, Mei-Dong Xu
Sheng-Xi Li, Department of Endoscopic Diagnosis and Therapy, People’s Hospital of Liaoning Province, Shenyang 110016, Liaoning Province, China
Hui Li, Department of Anesthesia, People’s Hospital of Liaoning Province, Shenyang 110016, Liaoning Province, China
Tao Chen, Mei-Dong Xu, Endoscopy Center, Zhongshan Hospital of Fudan University, Shanghai 200032, China
Author contributions: Li SX and Xu MD contributed to the conception and design; Li SX and Li H drafted the article; Chen T critically revised the article for important intellectual content; Xu MD approved the final copy of the article.
Correspondence to: Mei-Dong Xu, MD, PhD, Endoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Rd, Shanghai 200032, China. xu.meidong@zs-hospital.sh.cn
Telephone: +86-21-64041900 Fax: +86-21-64041900
Received: May 8, 2014
Revised: June 3, 2014
Accepted: June 27, 2014
Published online: September 16, 2014
Processing time: 133 Days and 15.3 Hours
Abstract

Foreign body ingestion is an emergency or acute situation that commonly occurs in children or adults and involves the ingestion of one or more objects. Moreover, once the discovery of swallowed foreign bodies has been made, families are typically very anxious to have the patient see a doctor. If the foreign object becomes embedded in the digestive tract, it must be removed; in emergencies, this is done by endoscopy or surgery. This case report presents the successful endoscopic retrieval of a chopstick with both sides embedded 4 cm into the esophageal wall for > 10 mo in a male patient following automutilation in an attempt to be released from a psychiatric hospital. Hot hemostatic forceps were used to open the distal esophageal mucosa in which the chopstick was embedded. The procedure was performed under intravenous general anesthesia and took approximately 7 h.

Keywords: Foreign body; Esophagus; Endoscopy; Chopstick; Gastroscope; Hot hemostatic forceps

Core tip: Foreign body ingestion is an emergency that often occurs in children or adults with psychiatric disorders or mental retardation. Here, we report the unique case of a chopstick lodged in the esophagus for 10 mo in a 50-year-old man. The chopstick was embedded 4 cm into the esophageal wall at both ends. Therefore, the procedure was performed under intravenous anesthesia. We made a 4-cm long incision, approximately 1 cm in depth in the esophageal mucosa using hot hemostatic forceps. This procedure took approximately 7 h to perform and an 18-cm long chopstick was removed.