Successful endoscopic removal of foreign body lacerating into the duodenum

Video 1The endoscope was advanced under direct visualization to the third part of the duodenum. A foreign body consistent with a ballpoint pen was identified in the duodenum. The sharp end of the pen formed a deep laceration through the second portion of the duodenum. The blunt end of the pen was ulcerated into the third portion of the duodenum with 2 additional pressure ulcers located in close proximity. Removal of the pen was first attempted using a snare without success. The foreign body was then successfully removed with a rat tooth. The second portion of the duodenum showed minimal oozing with contained deep laceration. The third portion of the duodenum showed 2 pressure ulcers.