Peroral enteroscopic removal of a retained percutaneous transhepatic guidewire from the jejunum using a colonoscope

Several authors have described the ability to perform small-intestine endoscopy with long, flexible fiberscopes. A peroral colonoscope has been used for small-bowel enteroscopy and biopsy. A pediatric colonoscope for jejunoscopy has been described. Herein we report a patient undergoing percutaneous transhepatic decompression for the extrahepatic biliary obstruction in whom the guidewire broke and was lost in the liver. The proximal end of the wire was within the liver, while the distal end exited the ampulla and lay within the upper jejunum. Utilizing a peroral approach with the flexible pediatric colonoscope, we recovered the guidewire without advancing it further into the jejunum, where it may have been lost and have necessitated a celiotomy.