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Needles may also lodge in the esophageal wall (Figure 4.15). Endoscopic removal of needles that protrude into the esophageal lumen is readily achievable. Needles that migrate through the esophageal wall to rest in the periesophageal tissues may prove very difficult to locate during surgical exploration. These difficulties are compounded by large body size. Intraoperative fluoroscopy is invaluable in these situations; increasing the chance of successfully finding the needle and limiting the extent of dissection required. Resolution of clinical signs is frequently very rapid. The author does not routinely administer antibacterial agents either in these cases or after retrieval of fishhooks.