Extraluminal Migration of Foreign Body: A Report of Two Cases

Abstract

Ingested foreign body is one of the most frequently encountered emergencies in otolaryngology practice. Many of these foreign bodies get lodged in the upper digestive tract and can be removed endoscopically. Few of these foreign bodies can perforate the upper digestive tract and an even smaller number of these can migrate extraluminally. Although, a migrating foreign body can remain quiescent, they can cause life-threatening suppurative or vascular complications; hence, location and removal is essential. Here we report two cases of extraluminal migration of foreign body which was removed by neck exploration.

Migrated subcutaneous sharp foreign body in the anterior chest wall: An unusual presentation

“…The mechanism of migration is believed to be due to the contraction of the muscles and viscera during voluntary or involuntary movements. 6 Sakuma et al reports the effective removal of a superior mediastinal foreign body in a 74-year-old male, by video-assisted mediastinoscopy. 7 In order to prevent the damage to the surrounding organs, it is advised to not remove the foreign body forcibly rather to dissect the surrounding tissues carefully.…”

Fishing for a fish bone: migratory foreign body in a regional hospital

“…CT allows accurate assessment of the foreign body in relation to the surrounding critical structures and to diagnose these potential complications 4 . Despite the utility of cross‐sectional imaging, our case highlights the challenging aspect of determining if the foreign body is partially or completely extraluminal 5 . Therefore, endoscopy with direct visualization remains a vital diagnostic tool.…”

“…4 Despite the utility of cross-sectional imaging, our case highlights the challenging aspect of determining if the foreign body is partially or completely extraluminal. 5 Therefore, endoscopy with direct visualization remains a vital diagnostic tool.…”

Retropharyngeal foreign body in a Down Syndrome girl

“…It is depends mainly on the nature of the foreign body and the period of the therapeutic management. 7 In this case, it is highly possible that the foreign body had dislodged and been swallowed because there was a delay from onset of symptom to the therapeutic intervention time. This finding was confirmed postoperatively by repeating the CT scan which revealed normal scan and no foreign body was seen.…”

“…It happened due to strong contraction of the muscles during swallowing and the mechanism of migration is thought to be due to movement of neck muscle and viscera during voluntary and involuntary movements of head and neck structures. 7 These migrating foreign bodies can cause life threatening deep neck abscess, such as parapharyngeal and retropharyngeal abscess that can lead to mediastinitis. It can also penetrate adjacent visceral structure and precipitate vascular complications.…”