Writing on the duodenal wall
A 29-year-old patient with a psychiatric history and foreign body ingestions presents with 1 day of moderate to severe abdominal pain. She is normotensive, tachycardic, and febrile. CT scan shows a foreign body consistent with a ballpoint pen in the second portion of the duodenum. Free fluid is in the subhepatic space, but pneumoperitoneum is not present. Attempts at endoscopic retrieval are undertaken with surgical assistance on standby. ASGE guidelines suggest or recommend which of the following for foreign body ingestions within reach of an upper endoscope?
Endoscopic removal of all objects of a diameter greater than 1 cm. Endoscopic removal of all objects of a length greater than 6 cm. Observation of blunt-shaped objects including magnets. Use of radiographic examinations with contrast to evaluate for obstruction.
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