Novel Approach to Endoscopic Foreign Body Retrieval From the Gastric Body

Foreign body (FB) ingestion is a common occurrence in the United States with a reported incidence of 120 per 1 million people, accounting for up to 1500 fatalities annually. The majority of FB ingestions will pass through the gastrointestinal tract spontaneously, while in 10% to 20% of patients, intervention will be necessary. A variety of endoscopic devices can be utilized to facilitate FB removal from the gastrointestinal tract, including snares, retrieval nets, and grasping forceps. We report the case of a 58-year-old female who required utilization of endoscopic scissors for FB removal in the setting of multiple failed attempts with traditional methods. This case highlights a novel approach to gastric FB removal utilizing endoscopic scissor forceps, which should be considered in select cases to further improve the efficacy of endoscopic FB removal and reduce the need for surgical intervention.

Endoscopic approach of suprasellar arachnoid cyst

A male 3-year-old child was referred to our service due to increasing head size and mild headache. On physical examination, head circumference was 55 cm (bigger than 97th percentile), the child was conscious, alert and oriented to person, place, time and event, his pupils were isochoric, the light reflex was bilaterally positive, eye movements showed a slight palsy on the abduction of the left eye, and a partial vision loss on the left eye was detected. Gait was also impaired. MRI presented a cystic lesion in the suprasellar region suggesting arachnoid cyst, associated with hydrocephalus. An endoscopic ventricular approach was performed through a straight incision over Kocher’s point. The cyst was easily identified, coagulated with cautery and incised with endoscopic scissors. A ball-valve mechanism was well visualized. Prepontine cistern was also sharply opened and the whole cyst wall was coagulated. The patient was discharged on the second postoperative day showing a clinical improvement. Late head CT presented also a radiologic improvement.