I.  Blunt Three-Dimensional Foreign Bodies (cont.)

C.  Removal with Suction Catheter

• The required material consists of  a 12-F, single-lumen nasogastric tube (Argyle, St. Louis, MO) is modified by cutting off the distal end proximal to all of the side holes.  This end of the tube is connected to a 60 ml syringe using a "Christmas tree" adapter.  The flared, proximal end of the tube should be made smooth with a nail file or pair of scissors.  
  
  

• The method is as followed:

  • The patient's throat is sprayed with a topical anesthetic.  

  • The flared end of the tube is passed through the mouth and esophagus down to the level of the foreign material.  

  • Suction is applied by the aspirating syringe, and the foreign body is sucked against the flared end of the tube.  Suction is maintained as the tube and foreign body are withdrawn (Fig. 2).  

  • If impacted food is fragmented, the tube may have to be passed several times to extract all of the fragments.  Limited clinical experience and cadaver studies suggest that this procedure is relatively effective and safe.

Fig. 2.  Suction catheter FB extractor.  The distal end of a single-lumen 12-F nasogastric tube is cut off to remove all side holes.  The cut end is attached to a 60-ml syringe with a "Christmas tree" adapter.  The flared end of the tube (arrow) is used to vacuum foreign material from the esophagus.  (From Shaffer HA Jr, de Lange EE.  Diagnosis and treatment of food impactions and foreign bodies in the esophagus.  In Taveras JM, Ferrucci JT (eds).  RADIOLOGY: Diagnosis/Imaging/Intervention.  Philadelphia.  J. B. Lippincott Co., 1994, Volume 4, Chapter 15B, pp 1-11.  Reproduced by permission.)