Endoscopic Foley Balloon Extraction of an Esophageal Foreign Body

풍선 도뇨관을 이용한 내시경적 식도 이물 제거 1예

  • Kim, Jin-Ou (Department of Internal Medicine, Seoul Red Cross Hospital) ;
  • Song, Jung-Hoon (Department of Internal Medicine, Seoul Red Cross Hospital) ;
  • Wang, Hee-Bae (Department of Internal Medicine, Seoul Red Cross Hospital) ;
  • Jeong, Eun-Ho (Department of Internal Medicine, Seoul Red Cross Hospital) ;
  • Ryu, Soo-Hyung (Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine) ;
  • Lee, Jung-Hwan (Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine) ;
  • Kim, You-Sun (Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine) ;
  • Moon, Jeong-Seop (Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine)
  • 김진우 (서울적십자병원 내과) ;
  • 송정훈 (서울적십자병원 내과) ;
  • 왕희배 (서울적십자병원 내과) ;
  • 정은호 (서울적십자병원 내과) ;
  • 류수형 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 이정환 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 김유선 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 문정섭 (인제대학교 의과대학 서울백병원 내과학교실)
  • Published : 2011.06.30

Abstract

Esophageal foreign bodies should be retrieved as soon as possible, as they may cause complications such as bleeding, perforation, and respiratory distress. Flexible endoscopy is the preferred method, because it is effective and safe, but rigid esophagoscopy or a surgical procedure should be considered if flexible endoscopy fails. Extraction with a Foley balloon is an effective method for removing blunt foreign bodies from the esophagus. The general technique used is to insert the catheter into the esophagus through the nose or mouth, place it in the distal part of the foreign body, balloon the catheter, and remove the foreign body by pulling the catheter out. This procedure is generally performed under fluoroscopy, but a few reports have used Foley balloon extraction during endoscopy. We report a case of an elderly woman with a blunt foreign body in the upper esophagus. After failing to remove the object by endoscopy, we removed it with a Foley balloon under endoscopy.

식도 이물은 자연 배출되지 않는 경우 궤양, 출혈, 천공, 흡인성 폐렴, 기도 폐쇄 등 심각한 합병증을 야기할 수 있어 신속히 제거해야 한다. 내시경이 일반적 치료로 이용되고 있으며, 내시경적 이물 제거에 실패한 경우 전신마취 하에 강직형 식도경이나 수술을 이용한 이물 제거를 고려한다. 풍선 도뇨관을 이용한 식도의 이물 제거술은 도뇨관을 비강 혹은 구강을 통해 식도로 삽입, 이물의 원위부까지 진입시킨 후 풍선을 확장해 천천히 당겨 제거하는 방법으로 둔형의 이물 제거에 효과적인 것으로 알려져 있다. 보통 투시검사 하에 시술하지만 내시경 관찰 하에 시행하였다는 보고는 드물다. 저자들은 둔형의 상부식도 이물로 내원한 환자에게 여러 보조 기구를 이용하여 내시경적 이물 제거를 시도하였으나 실패한 후, 강직형 식도경이나 수술적 방법을 선택하기 전 풍선 도뇨관을 이용하여 큰 합병증 없이 이물 제거에 성공하여 보고한다.

Keywords

References

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