Extraluminal migration of ingested fish bone in the upper aerodigestive tract: A series of three cases with broad clinical spectrum of manifestations and outcomes

Koh, Wei Jie; Lum, Sai Guan; Al-Yahya, Syarifah Nafisah; Shanmuganathan, Jothi

doi:10.1016/j.ijscr.2021.106606

Cited by 3 publications

(1 citation statement)

References 10 publications

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“…Food that is causing an esophageal obstruction can be gently pushed into the stomach, while foreign bodies that are unsuitable or unable to be pushed into the stomach can be removed by a snare, graspers, a stone extraction mesh basket, a balloon, a holmium laser and other tools after the types and positions are identified endoscopically[ 12 ]. However, for patients showing throat and neck discomfort after eating fish without fishbones detected by endoscopy, the possibility of esophageal perforation combined with the fishbone migrating to other locations should be considered[ 13 ], as constriction of swallowing muscles and peristalsis of the esophagus can force the fishbone to penetrate the mucosa and move out of the oropharynx[ 14 ]. An abscess can be formed 3-4 d after the fishbone moves out of the oropharynx into the neck[ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Bedside ultrasound-guided water injection assists endoscopically treatment in esophageal perforation caused by foreign bodies: A case report

Wei¹,

Lv²,

Xia³

et al. 2023

World J Gastrointest Surg

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BACKGROUND Fishbone migration from the esophagus to the neck is relatively uncommon in clinical practice. Several complications secondary to esophageal perforation after ingestion of a fishbone have been described in the literature. Typically, a fishbone is detected and diagnosed by imaging examination and is usually removed by a neck incision. CASE SUMMARY Herein, we report a case of a 76-year-old patient with a fishbone in the neck that had migrated from the esophagus and that was in close proximity to the common carotid artery, and the patient experienced dysphagia. An endoscopically-guided neck incision was made over the insertion point in the esophagus, but the surgery failed due to having a blurred image at the insertion site during the operation. After injection of normal saline laterally to the fishbone in the neck under ultrasound guidance, the purulent fluid outflowed to the piriform recess along the sinus tract. With endoscopic guidance, the position of the fish bone was precisely located along the direction of liquid outflow, the sinus tract was separated, and the fish bone was removed. To the best of our knowledge, this is the first case report describing bedside ultrasound-guided water injection positioning combined with endoscopy in the treatment of a cervical esophageal perforation with an abscess. CONCLUSION In conclusion, the fishbone could be located by the water injection method under the guidance of ultrasound and could be accurately located along the outflow direction of the purulent fluid of the sinus by the endoscope and was removed by incising the sinus. This method can be a nonoperative treatment option for foreign body-induced esophageal perforation.

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Section: Discussionmentioning

confidence: 99%

Bedside ultrasound-guided water injection assists endoscopically treatment in esophageal perforation caused by foreign bodies: A case report

Wei¹,

Lv²,

Xia³

et al. 2023

World J Gastrointest Surg

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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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Two cases of extraluminal migration of fishbones into the thyroid gland and submandibular gland

et al. 2022

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Laryngopharyngeal or cervical pain following ingestion of foreign bodies is one of the most frequently encountered emergencies in otolaryngologic practice. Although most of these foreign bodies can be easily removed under laryngoscopic examination without any complications, surgical removal may be required when foreign bodies migrate extraluminally. This report describes two rare cases of ingested fishbones that had migrated, one each to the thyroid gland and submandibular gland. Extraluminal migration fishbones should always be considered in otolaryngologic clinics.

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Extraluminal migration of ingested fish bone in the upper aerodigestive tract: A series of three cases with broad clinical spectrum of manifestations and outcomes

Cited by 3 publications

References 10 publications

Bedside ultrasound-guided water injection assists endoscopically treatment in esophageal perforation caused by foreign bodies: A case report

Bedside ultrasound-guided water injection assists endoscopically treatment in esophageal perforation caused by foreign bodies: A case report

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

Two cases of extraluminal migration of fishbones into the thyroid gland and submandibular gland

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