Oestrogen and androgen receptors in breast cancer and response to endocrine therapy.

Abstract

of the impacted safety pin had clearly ceased.Also the pin had caused epigastric pain and a small haemorrhage, and required removal.In view of the previous abnormalities in the right upper abdomen and the patients' cardiac status, laparotomy and duodenotomy would have been technically difficult and of considerable risk to the patient.Fibre-optic endoscopy has found a number of diagnostic and therapeutic applications in diseases of the upper digestive tract.Although the second part of the duodenum is accessible using the endoscope, the special devices marketed for the removal of foreign bodies were of little use in this case because of the extreme flexion of the tip required.Fortunately, the biopsy forceps fitted the loop of the ingested safety pin and the pin was lying the appropriate way for its retrograde removal.The advantages of endoscopic removal in this case are clear, but the obviation of general anaesthesia, laparotomy, and a period of postoperative recovery apply equally to the fit patient.If the patient had presented at hospital while the pin was still in the stomach its removal would have been much easier.Ingested foreign bodies that are likely to impact in the bowel should be removed from the stomach as a matter of urgency when endoscopy is to be used.