Endoscopic removal of foreign bodies from the stomach is among the most common emergency indications in gastrointestinal endoscopy. Needle ingestion is a particularly common among women who secure their headscarves with needles. The main complications that may occur during the extraction procedure are mucosal injury, bleeding, laceration, or perforation of the stomach and esophagus. In this study, we evaluated the presence and severity of esophageal injury during the removal of a swallowed needle using an easily accessible and low-cost modified condom catheter attached to the tip of the gastroscope.

Fourteen female patients who accidentally swallowed a needle were admitted to the emergency department. After radiologic imaging confirmed that the foreign body was located in the stomach, endoscopic removal was performed under sedation with midazolam and meperidine. Before the procedure, a condom catheter with 35 mm diameter was modified by cutting and adapted to the tip of the gastroscope. Since swallowed needles could not be found in 2 patients, 12 patients were evaluated. During the procedure, the proximal one-third of each needle was grasped with a snare, and once the modified condom catheter cap at the gastroscope tip completely enclosed the needle at the esophagogastric junction, the instrument was withdrawn. Post-procedure endoscopic examinations were performed to assess possible esophageal mucosal damage, and the lengths of the removed needles were measured. Descriptive analysis was performed.

The mean age of the 12 female patients was 27.7 ± 8.7 years. All reported accidental needle ingestion while wearing a headscarf. The mean length of the extracted needles was 24.7 ± 6.2 mm (range: 15–35 mm). Follow-up endoscopic evaluations revealed no mucosal injury or laceration in any patient. All patients were discharged following the procedure.

In this small case series of 12 patients with ingested needles, the use of a modified condom catheter attached to the gastroscope tip in conjunction with a snare was associated with successful retrieval without any endoscopically detectable esophageal mucosal injury. This easily accessible and low-cost modification may represent a useful adjunct in selected cases; however, larger comparative studies are needed to confirm its safety and efficacy.