Alternative salvage technique for removing large sharp foreign body near upper esophageal sphincter

Removing sharp foreign bodies located in the esophagus can be dangerous and challenging. Proper apparatus and appropriate technique should be employed to avoid life-threatening complications such as perforation and mediastinitis. A 59-year-old man came to the emergency department with foreign body sensation in the upper esophagus which proved to be a large sharp fish bone impacted near upper esophageal sphincter. With the ordinary upper endoscope, the foreign body could not be retrieved even with the assistance of a cap. Foreign body removal was attempted again using a colonoscope with cap fitted at the end. Larger caliber of the scope rendered more stable support within the lumen enabling better maneuver of the scope tip to secure wider working space, and application of the cap permitted better visual field. Herein, we report the first case of successful removal of a large sharp fish bone impacted near the upper esophageal sphincter using cap assisted colonoscope.