E0183 - Use of a Novel Attachment Device to Aid in Endoscopic Food Impaction Removal

Zoe Lawrence, MD¹, David Dornblaser, MD¹, Johann Hasbun, MD¹, Barathi Sivasailam, MD², Melissa Latorre, MD, MS^2
1NYU Langone Health, New York, NY; ²New York University Langone Medical Center, New York, NY

Introduction: Esophageal food impaction is one of the most common gastrointestinal emergencies. Unfortunately, tools for foreign body removal from the esophagus are limited and upper endoscopies for food impaction are often prolonged procedures that require the use of multiple tools. Adding to the armamentarium of tools is a novel single-use attachment device consisting of a plastic cap that fits over the end of the endoscope with a snare threaded through it designed for use in foreign body removal.

Case Description/Methods: Four patients, ranging in age from 28 to 54 years, presented separately to the emergency room with sensations of food stuck in the esophagus after eating meat. All were hemodynamically stable and had no improvement with glucagon. On endoscopy, food bolus was seen in the esophagus in all patients and three of the four patients had evidence of eosinophilic esophagitis. Attempts to gently push the boluses into the stomach were unsuccessful, so the combination cap and snare device was attached. With this device, each ~4cm food bolus was removed entirely in one pass before reinsertion of the endoscope to complete the exam.

Discussion: Use of a transparent cap in addition to standard accessory devices such as rat tooth forceps has been shown to decrease procedure time in upper endoscopy food impaction (1,2). Conventional esophageal food impaction endoscopies have a procedure time of approximately 47 minutes and the addition of a cap decreases procedure time to 23 minutes (2). The above cases required only one pass of the endoscope to remove the food bolus, demonstrating that the use of the cap and snare device has the potential to significantly decrease endoscopy procedure time in these often complex cases.



1. Zhang, Shenghong, et al. "Transparent cap‐assisted endoscopic management of foreign bodies in the upper esophagus: a randomized, controlled trial." Journal of Gastroenterology and Hepatology 28.8 (2013): 1339-1342.

2. Ooi, Marie, et al. "Comparison of cap-assisted vs conventional endoscopic technique for management of food bolus impaction in the esophagus: results of a multicenter randomized controlled trial." The American Journal of Gastroenterology 116.11 (2021): 2235-2240.




Disclosures:


Zoe Lawrence, MD¹, David Dornblaser, MD¹, Johann Hasbun, MD¹, Barathi Sivasailam, MD², Melissa Latorre, MD, MS². E0183 - Use of a Novel Attachment Device to Aid in Endoscopic Food Impaction Removal, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.