Case report: Ultrasound diagnosis of fish bone penetration into the thyroid

Cavelier, Gaëtan; Ostermann, Katharina; Horoi, Mihaéla; Huvenne, R; Dequanter, Didier; Rodriguez, Alexandra

doi:10.1002/ccr3.2589

Cited by 7 publications

(7 citation statements)

References 6 publications

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“…In addition, it can be assumed that local inflammation was more pronounced after 4d when the second ultrasound was performed which could have facilitated the diagnosis. Our case is in line with previous studies showing that CT and ultrasound are both appropriate and complementary imaging techniques to detect foreign bodies [2,8,10]. On the one hand, ultrasound is broadly available, cost effective and without ionizing radiation and can be used by an experienced investigator to detect foreign bodies, tissue alterations or liquid formations [14].…”

Section: Discussionsupporting

confidence: 89%

“…A comparison of individual cases attests to how variable patient histories, time courses and clinical presentations can be. While an immediate onset of symptoms after consumption of fish facilitates a prompt diagnosis, unspecific symptoms for months or a resolution and return of pain over time can delay or even complicate diagnosis [8][9][10]. Consequently, the detection of a migrated fish bone might become an interdisciplinary diagnostic challenge.…”

Section: Discussionmentioning

confidence: 99%

“…This was suspected to be a fish bone (arrows) tissue like the soft tissue of the neck [12,13]. Furthermore, the mucosa can present without any lesion or pathology even after migration of the fish bone [10]. Therefore, further diagnostics are recommended, especially when symptoms do not resolve or quickly worsen and when signs of infection develop.…”

Section: Discussionmentioning

confidence: 99%

“…In cases of foreign body migration causing suppurative thyroiditis, antibiotic treatment is immediately initiated in most cases but without delaying causal therapy and resection of the infectious focus. Otherwise, suppurative thyroiditis can progress to retrotracheal/retropharyngeal abscess formation, mediastinitis and sepsis to become life-threatening [17]: Interestingly, Cavelier et al provided preoperative antibiotic treatment for 15 days before surgical treatment of the thyroid gland after fish bone migration suggesting delayed surgery is viable [10]. However, as in most cases The degree of surgical resection required to remove a foreign body in the thyroid gland can vary from none to hemithyroidectomy to complete thyroidectomy [2,18].…”

Section: Discussionmentioning

confidence: 99%

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Suppurative thyroiditis caused by ingested fish bone in the thyroid gland: a case report on its diagnostics and surgical therapy

et al. 2022

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Background Accidental ingestion of fish bone is a common cause of otolaryngological emergency. Migration of the ingested bone into the thyroid gland, however, occurs very rarely. The associated clinical presentation, symptoms and duration of discomfort are also highly variable between patients and can be diagnostically challenging. Case presentation Here, we report the case of a 71-year-old female patient presenting with an ingested fish bone that migrated into the right thyroid lobe as a rare cause of suppurative thyroiditis with the clinical features of sepsis. We outline the diagnostic approach, peri- and intraoperative management as well as complications. It is proposed that besides endoscopy, imaging methods such as ultrasound or computed tomography may be necessary to verify the diagnosis and location of an ingested fish bone. Prompt surgical removal of the foreign body and resection of the infectious focus is recommended to minimize the risk of local inflammation, recurrent nerve lesions and septic complications arising from the spread of infection. Conclusion Fish bone migration into the thyroid gland is an extremely rare event, the successful detection and surgical management of which can be achieved through a careful interdisciplinary approach.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Suppurative thyroiditis caused by ingested fish bone in the thyroid gland: a case report on its diagnostics and surgical therapy

et al. 2022

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“…The diagnostic methods of foreign body invasion include X-ray, CT, ultrasonography, esophagoscopy, and laryngoscopy ( 17 ). Esophagoscopy or laryngoscopy examinations are usually regarded as the preferred methods when a foreign body is ingested because they can also be used as therapeutic tools.…”

Section: Discussionmentioning

confidence: 99%

Misdiagnosis of thyroid penetration caused by fishbone ingestion: a case report and literature review

Sun¹,

Yuan²,

Yin³

et al. 2023

Gland Surg

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Background: Foreign body ingestion is a common occurrence. However, thyroid penetrating injury caused by fishbone migration is rare.Case Description: In this study, we present a rare misdiagnosed case of a fishbone fixed in the thyroid with a negative diagnosis on laryngoscopy examination. A 52-year-old woman experienced severe and persistent left anterior cervical pain when eating fish. Laryngoscopic imaging at an external hospital, revealed a cyst with a maximum length of 2 cm on the epiglottis, and epiglottic cyst resection under a laryngoscope was performed. The pain was not relieved, and the patient was referred to our hospital. Computed tomography and ultrasound examinations showed a sloping foreign body with a length of approximately 2.5 cm from top to bottom in the left lobe of the thyroid gland. The possibility of a penetrating fishbone injury was considered, and the foreign body was surgically removed. Postoperative drainage, fasting, and antibiotics were prescribed for 3 days, and then the patient was discharged. Follow-ups for 40 days suggested that she had recovered well without complications. Conclusions:The presence of a migratory fishbone should be considered when a patient has a history of fishbone ingestion but laryngoscopy or esophagoscopy assessment of foreign body ingestion is negative.

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Ensuring that ingested fishbones that migrate to the neck are located, diagnosed, and removed early

Ouyang,

Shi,

Wang

2024

Eur Arch Otorhinolaryngol

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Objectives The aim of this retrospective study was to explore the clinical characteristics of and diagnostic and therapeutic strategies for the removal of fish bones that migrate to the neck. Methods We reviewed the clinical data of 30 patients over the past 12 years who underwent neck surgery in our otorhinolaryngology department for the migration of fish bones from the throat. The location of fish bones and the positivity rate of different examination methods (neck CT and B-ultrasound) were evaluated statistically. The diagnosis and treatment strategy for fish bone migration to the neck was also summarized. Results A total of 24 patients had a history of foreign body ingestion. The duration from foreign body ingestion to the appearance of symptoms in the neck ranged from 26 to 151 days, with a median of 50 days (interquartile range, 32–86 days). Among the 24 patients with fish bones located in the front or side of the neck, 50% (12/24) and 100% (24/24) of whom had positive neck CT and B-ultrasound results, respectively. Additionally, for 6 patients with fish bones in the retropharyngeal space, the positive rate for neck CT was 100%, whereas neck B-ultrasound showed negative results due to the air and depth in the trachea and esophagus. A strong correlation was observed between the length of fish bones detected by B-ultrasound and CT and the actual length. Indeed, no significant difference was observed between the length of fish bone determined by B-ultrasound and the actual length. In patients with fish bones located in the anterior and lateral neck regions, the foreign bodies were successfully removed by a lateral cervical approach operation (23/24). For the 6 cases with fish bones located in the retropharyngeal space, all (6/6) were removed by incising the posterior pharyngeal wall with assistance from transoral endoscopy. Conclusions The techniques of B-ultrasound and CT have advantages for the diagnosis of migratory foreign bodies in the neck. Although B-ultrasound is more accurate for estimating the length of migratory fish bones in the neck, a combination of both methods can improve the preoperative positive rate of diagnosis. Therefore, a variety of surgical approaches should be employed to manage the different locations of cervical foreign bodies.

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Case report: Ultrasound diagnosis of fish bone penetration into the thyroid

Abstract: Key Clinical Message Ultrasonography is useful in the diagnosis of foreign body migrations (eg, fish bones) into the soft tissues of the neck.

Cited by 7 publications

References 6 publications

Suppurative thyroiditis caused by ingested fish bone in the thyroid gland: a case report on its diagnostics and surgical therapy

Suppurative thyroiditis caused by ingested fish bone in the thyroid gland: a case report on its diagnostics and surgical therapy

Misdiagnosis of thyroid penetration caused by fishbone ingestion: a case report and literature review

Ensuring that ingested fishbones that migrate to the neck are located, diagnosed, and removed early

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