Endoscopic removal of multiple sharp gastro-duodenal foreign bodies

A 45 years old female,with bipolar disorder,was brought to the Emergency Department with abdominal pain. The patient was hemodynamically stable,with no signs of respiratory distress. On abdominal examination she had pain in the upper quadrants,without peritoneal irritation. The successful endoscopic removal decreases if delayed approach, beyond 12 h, and sharp objects. Moreover in case of sharp objects, even if already into the stomach or duodenum, they should be retrieved endoscopically if it can be accomplished safely, because the risk of a complication during its natural exteriorization is as high as 35%. Extreme caution is required as it is easy to injure the wall of the gastrointestinal tract, in order to that one method involves using an overtube to protect the esophagus and another technique fashioning a protective hood. Instead we were able to remove all the needles without complication using the method described above. Lately we found in literature a similar description although using a sheath - a good option to obviate any risk for the endoscope.