Endoscopic Retrieval of Esophageal Fishhooks Using Cerclage Wire: A Case Report

내시경과 Cerclage Wire를 이용한 식도내 낚시바늘 제거: 증례보고

  • Kim, Young-Ki (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Uhm, Mi-Young (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Seo, Eu-Gene (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Ha, Mi-Hyun (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Wang, Ji-Hwan (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Jeong, In-Jo (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Chang, Hong-Hee (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Lee, Hee-Chun (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Cho, Kyu-Woan (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Lee, Hyo-Jong (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Yeon, Seong-Chan (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University)
  • 김영기 (경상대학교 수의과대학 동물의학연구소) ;
  • 엄미영 (경상대학교 수의과대학 동물의학연구소) ;
  • 서유진 (경상대학교 수의과대학 동물의학연구소) ;
  • 하미현 (경상대학교 수의과대학 동물의학연구소) ;
  • 왕지환 (경상대학교 수의과대학 동물의학연구소) ;
  • 정인조 (경상대학교 수의과대학 동물의학연구소) ;
  • 장홍희 (경상대학교 수의과대학 동물의학연구소) ;
  • 이희천 (경상대학교 수의과대학 동물의학연구소) ;
  • 조규완 (경상대학교 수의과대학 동물의학연구소) ;
  • 이효종 (경상대학교 수의과대학 동물의학연구소) ;
  • 연성찬 (경상대학교 수의과대학 동물의학연구소)
  • Published : 2007.12.31

Abstract

A 1.6-year-old, intact male beagle dog was presented with three day history of odynophagia and anorexia. According to the history and radiographic findings, the patient was diagnosed with esophageal and gastric foreign body due to ingesting fishhooks. Gastroesophagoscopy revealed that one fishhook located in the thoracic esophagus cranial to the heart base and the other located in the cardia region were connected with a single fishing line. Gastrotomy was performed to remove the fishhook in the cardia region and to sever the connecting fishing line. After gastrotomy, endoscopic attempts to remove the esophageal fishhook with a three, five pronged endoscopic grasping forceps, and a biopsy were unsuccessful because the fishhook was embedded deeply in the mucosa membrane. A handmade cerclage wire(16G) shaped like a snare forceps was advanced into the esophagus while visualizing the fishhook endoscopically. The cerclage wire was used to hang and retract the foreign body. The fishhook was retracted orally, resulting in successful removal. Ten days after the operation, the patient fully recovered and was discharged.

1년 6개월령의 수컷 비글견이 3일간의 연하통증과 식욕부진으로 내원하였다. 환축은 병력청취와 방사선학적 검사결과 낚시바늘에 의한 식도와 위내 이물로 진단되었다. 위식도 내시경을 시행한 결과 하나의 낚시바늘은 흉부식도의 심장기저 부에 나머지 하나의 낚시바늘은 위 분문부에 위치하고 있었다. 그리고 두 낚시바늘은 하나의 낚싯줄로 서로 연결되어 있었다. 연결된 낚싯줄을 끊고 위내 낚시바늘을 제거하기 위해 위 절개술을 시행하였다. 위 절개술 후 식도내 바늘을 제거하기 위해 세 갈래, 다섯 갈래 내시경 포셉과 생검 포셉을 이용한 내시경적 제거를 시도하였으나 낚시바늘이 식도의 점막에 깊게 박혀있어 견인에 실패하였다. 낚시바늘을 더욱 단단히 잡아줄 수 있는 장치를 위해 정형외과용 스테인리스 와이어(16G)를 올가미 포셉 형태로 제작한 뒤 내시경을 통한 시야가 확보된 상태에서 바늘에 걸어 제거하는데 성공하였다. 시술 10일 후 환축은 회복되어 퇴원조치 되었다.

Keywords

References

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