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November 1, 1976

Management of Foreign Bodies in the Esophagus-Reply

Author Affiliations

Hackettstown, NJ

JAMA. 1976;236(18):2054. doi:10.1001/jama.1976.03270190016017

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So,Dr Kleinman and I disagree. And again, I have the distinct feeling that many of today's gastrointestinal endoscopists (upper and lower) keep trying to make a single instrument do for every endoscopic job, whether or not it be the instrument best designed to do the job.

Dr Kleinman's technique is too dangerous. First, it "often takes three to six passages" of the endoscope, thereby making the threat of endoscopic perforation three to six times greater than it need be. Second, it requires blind passage of the snare around and beyond the obturating mass, into areas whose condition is almost always unknown to the endoscopist. (I believe a few experiences with unsuspected varices might dampen anyone's enthusiasm.)