Analysis of Clinical Feature and Management of Fish Bone Ingestion of Upper Gastrointestinal Tract

Abstract

ObjectivesFish bone impaction in the upper gastrointestinal tract is a common reason for patients to seek emergent care. The aim of this study was to find a clinical characteristics of patients with fish bone impaction in the upper gastrointestinal tract.MethodsThe study was conducted on 286 fish bone ingestion patients who complained of dysphagia and irritation after eating fish. The patients were treated according to the hospital protocol regarding the removal of fish bone. The parameters for the analysis included the age and sex of the patients, location and characteristics of the foreign body, method of removal, and type of fish.ResultsThe fish bone could be observed by the physical examination in the oral cavity and laryngopharynx in 198 patients (69.23%). For those patients in whom the foreign body could not be observed in oral cavity and laryngopharynx, noncontrast computed tomography (CT) (from nasopharynx to diaphragm) was performed. The fish bone was discovered in the esophagus of 66 patients (23.08%). The esophageal fish bone was successfully removed by transnasal flexible esophagoscopy (TNE) in 55 patients, the fish bone moved to the stomach in 10 patients and one fish bone was removed by rigid esophagoscopy due to esophageal abscess. The esophageal fish bone was mostly found in patients aged 50 years and older.ConclusionFish bone foreign body ingestion in the esophagus appeared to be more common in older patients. Incorporating noncontrast CT and TNE can facilitate decision-making and adequate treatment for patients with fish bone impactions.

The Utility of Diagnostic Imaging in Fish Bone Impaction

“…However Kim et al have reported similar findings to our study [14]. This difference was thought to be related to the physiological characteristics of the oesophagus and the deterioration in swallowing movement that occurs with increasing age [14] [15].…”

Tracheobronchial foreign body removal in infants who had very small airways: A prospective clinical trial

“…[13][14][15][16] Foreign body aspiration is mainly referred to between the ages of 1 and 3 years, and the percentage varies from 64% to 77%. [17][18][19][20][21][22] For infants, the removal of airway foreign bodies is performed under general anesthesia, using a ventilating rigid bronchoscope or bronchofibroscope. Though rigid bronchoscope is difficult to operate, it provides good vision and adequate clamping force so that it can more effectively and faster remove the life-threatening airway foreign bodies and this is compared with a bronchofibroscope.…”

Cervical oesophageal perforation secondary to food consumption in a well-appearing patient

“…While X-rays are often still the first diagnostic modality used given widespread availability, the published sensitivity of X-ray detection for fishbones ranges from just 27% to 57% 10. CT scan, on the other hand, has been shown to have a sensitivity of 100% and specificity of 93.7% 11. In our case, despite having a preoperative CT scan to localise the fishbone, we were initially unable to find the object in the neck, and formal intraoperative X-rays also did not detect the bone.…”