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VideoGIE| Volume 84, ISSUE 3, P535-536, September 2016

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Impacted chicken bone extracted with the aid of Nd:YAG laser

Published:March 25, 2016DOI:https://doi.org/10.1016/j.gie.2016.03.1473
      Chicken bone impaction in the colon is uncommon. We present a case of endoscopic chicken bone extraction with the aid of Nd:YAG laser. An 84-year-old woman presented with episodic lower abdominal pain. There was no history of foreign body ingestion. Initial colonoscopy identified a 3-cm × 4-cm V-shaped chicken bone impacted into opposite walls of the sigmoid colon. A CT scan was performed to assess the depth of the chicken bone penetration. A full-thickness perforation was excluded, and there was no associated pericolonic collection (Fig. 1A). A repeat colonoscopy was scheduled to remove the bone (Video 1, available online at www.giejournal.org). Because the chicken bone was impacted into opposite walls of the colon, it was decided to cut the bone into 2 pieces using Nd:YAG laser before removal. The 2 resultant pieces were retrieved with rat-tooth grasping forceps (Fig. 1B). Reinspection of the colon showed no evidence of perforation. A follow-up enema with contrast medium excluded a leak, and the patient was discharged home. There was complete resolution of the patient’s symptoms after chicken bone removal. Follow-up colonoscopy at 3 months showed mild granulation tissue reaction at the site.
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      Figure 1A, Abdominal CT showing the impacted chicken bone. B, Extracted chicken bone.
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