Endoscopic Removal of an Impacted Needle with Syringe from the Esophagus

Background: In adults, non-food foreign body ingestions occur more in denture users, incarcerated individuals, and in patients with psychiatric disorders or alcohol intoxication. The majority of the ingested foreign body will pass spontaneously. Sharp or pointed foreign body, animal or fish bones, and magnets increase the risk of perforation. Patient: An incarcerated patient with bipolar disorder swallowed a 14. cm in length needle attached with a syringe three months prior to presentation. The needle penetrated the distal esophagus leading to mediastinitis. Methods: In this video manuscript, we demonstrated endoscopic techniques on how to remove this 14. cm long sharp object. Results: The foreign body was removed uneventfully and mediastinitis resolved with antibiotic treatment. Conclusions: Emergent endoscopy is indicated in (1) esophageal obstruction and the patient are unable to swallow secretions and (2) disk batteries and sharp-pointed foreign body in the esophagus.