A foreign body (a fish bone) in the esophagus translocating into soft tissues of the neck – a case report

Abstract

Background: Patients with foreign bodies in upper digestive tract not infrequently trigger many diagnostic and treatment challenges, especially when foreign bodies translocate and are lodged outside the esophagus. Case report: We present a case of a foreign body in esophagus 56-years old woman who had developed persistent sensation of an obstacle in her throat after eating fish (Atlantic cod). She has initially dismissed her symptoms and refused medical treatment. Subsequently, a neck CT done one week later showed a 20-milimeter long fish bone in the soft tissues on the left side of her neck (between pharynx and vertebral column). Few attempts of endoscopic removal were unsuccessful. Despite antibiotic prophylaxis and due to the fish bone translocation into soft tissues of the neck and its location close to a common carotid artery and an internal jugular vein a decision was made to remove it from the external approach. The foreign body was successfully removed without any esophageal damages. Conclusions: Foreign bodies in digestive tract may result in many life-threatening complications. The fundamental management is based on the endoscopic removal of a foreign body and the antibiotic prophylaxis. In case of foreign bodies lodged in soft tissues open surgery is recommended. Key words: foreign body in the esophagus; fish bone; paraesophageal abscess ; treatment