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      Extraction of swallowed toothbrush in stomach by pneumatic insufflation and gastrotomy under local anesthesia: A rare occurrence

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          Abstract

          Most of the ingested foreign bodies pass uneventfully through the gastrointestinal tract. However, long and rigid foreign bodies are associated with an increased risk of gastrointestinal impaction, perforation, and bleeding. Spontaneous passage of a toothbrush has not been reported till date and the technique of its removal is a curiosity for surgeons. Endoscopy is a recommended technique for the removal of such complex foreign bodies. However, if it fails, the foreign body can be removed successfully with a laparoscopic gastrotomy. We devised an innovative technique by using pneumatic gastric insufflation and extracted the toothbrush by a tiny gastrotomy under local anesthesia.

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          Most cited references12

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          Endoscopic management of foreign bodies in the upper-GI tract: experience with 1088 cases in China.

          Reports on endoscopic management of ingested foreign bodies of the upper-GI tract in China are scarce. To report our experience and outcome in the management of ingestion of foreign bodies in Chinese patients. Between January 1980 and January 2005, a total of 1088 patients (685 men and 403 women; age range, 1 day to 96 years old) with suspected foreign bodies were admitted to our endoscopy center. All patients underwent endoscopic procedure after admission. Demographic and endoscopic data, including age, sex, and referral sources of patients, types, number and location of foreign bodies, associated upper-GI diseases, endoscopic methods, and accessory devices for removal of foreign bodies were collected and analyzed. A total of 1090 foreign bodies were found in 988 (90.8%) patients. The types of foreign bodies varied greatly: mainly food boluses, coins, fish bones, dental prostheses, or chicken bones. The foreign bodies were located in the pharynx (n = 12), the esophagus (n = 577), the stomach (n = 441), the duodenum (n = 50), and the surgical anastomosis (n = 10). The associated GI diseases (n = 88) included esophageal carcinoma (33.0%), stricture (23.9%), diverticulum (15.9%), postgastrectomy (11.4%), hiatal hernia (10.2%), and achalasia (5.7%). A rat-tooth forceps and a snare were the most frequently used accessory devices. The success rate for foreign-body removal was 94.1% (930/988). Ingestion of foreign bodies is a common clinic problem in China. Endoscopy procedures are frequently performed, and a high proportion of patients with foreign bodies require endoscopic intervention.
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            Foreign bodies.

            The spectrum of gastrointestinal (GI) foreign bodies includes food bolus impaction in the esophagus, nonfood objects that are swallowed, and various objects that may be inserted into the rectum. The risk depends upon the type of object and its location. Fortunately, 80% to 90% of ingested foreign bodies will pass without intervention. Objects with sharp edges or pointed tips have the highest risk of complications, up to 35%. All objects impacted in the esophagus require urgent or emergent treatment. Rectal foreign bodies are usually removable transanally, although general anesthesia and operative intervention sometimes are required.
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              A swallowed toothbrush.

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                Author and article information

                Journal
                J Res Med Sci
                J Res Med Sci
                JRMS
                Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences
                Medknow Publications & Media Pvt Ltd (India )
                1735-1995
                1735-7136
                May 2014
                : 19
                : 5
                : 472-473
                Affiliations
                [1]Department of Surgery, Rama Medical College and Research Centre, Mandhana, Kanpur, Uttar Pradesh, India
                [1 ]Department of Medicine, SGL Cheritable Hospital, Jalandhar, Punjab, India
                [2 ]Department of Surgery, SGL Cheritable Hospital, Jalandhar, Punjab, India
                Author notes
                Address for correspondence: Dr. Mahesh Gupta, Department of Surgery, Rama Medical College and Research Centre, Mandhana, Kanpur, India. E-mail: gm982003@ 123456yahoo.co.in
                Article
                JRMS-19-472
                4116581
                1df1b68f-6762-4e0c-941c-e94edaab2690
                Copyright: © Journal of Research in Medical Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 18 June 2013
                : 14 July 2013
                : 22 July 2013
                Categories
                Case Report

                Medicine
                gastrotomy,local anesthesia,toothbrush,upper gastrointestinal endoscopy
                Medicine
                gastrotomy, local anesthesia, toothbrush, upper gastrointestinal endoscopy

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