Clinical presentation
A 24 year old male was admitted having swallowed a packet containing 17 tablets of buprinorphine (subatex) and complaining of dysphagia and odynophagia. On examination he was haemodynamically stable with a respiratory rate of 15/min and saturating at 96% on room air. Clinical examination was unremarkable and a chest x ray was normal. Endoscopy was requested by his admitting team.
At endoscopy the patient's oesophagus was normal and a packet of about 5×2×3 cm in size was seen in the stomach (fig 1).
Figure 1 Endoscopy of the stomach showing a packet of about 5×2×3 cm in size.
Question
What would you do next?
Do nothing hoping that it would pass naturally?
Retrieve using polypectomy snare or stone removal basket?
Retrieve using Roth net?
Do nothing and refer the patient for surgical removal of the packet?
See page 1155 for answer
This case is submitted by: