Fish Bones at the Cricopharyngeus: A Comparison of Plain‐Film Radiology and Computed Tomography

Palme, Carsten E.; Lowinger, David; Petersen, Alexander J.

doi:10.1097/00005537-199912000-00011

Cited by 42 publications

(27 citation statements)

References 13 publications

(22 reference statements)

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“…17,18 CT was reported to be superior to plain film and barium swallow, and may be a safe alternative to OGD. If a patient refuses to undergo endoscopic examination, CT scan may be a safe alternative, if indicated.…”

Section: Discussionmentioning

confidence: 98%

Management of Foreign Bodies in Throat: An Emergency Department's Perspective

Chiu¹,

Chung²

2002

Hong Kong Journal of Emergency Medicine

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Objectives:To review the share of emergency physicians and surgeons in the removal of foreign bodies in throat, and to revisit the concept of home observation and elective endoscopic examination for this group of patients. Design: Retrospective study for a five month period. Setting: Public general hospital with emergency and surgical departments. Population: All patients attending the emergency department from 1st January 1999 to 31st May 1999 with a diagnosis or chief complaint of foreign body in throat or foreign body ingestion. Main outcome measures: Success rate of foreign body retrieval, method of removal, specialty and patient outcome. Results: 79.8% of the foreign bodies were fish bones. Eighty-nine percent foreign bodies was removed by direct laryngoscopy in the emergency department, 6.7% by emergency physicians in the endoscopy unit as outpatients and 4.3% by surgeons after admission. Conclusion: In the absence of frank clinical or radiological sign, a short period of home observation before proceeding to elective oesophagogastro-duodenoscopy (OGD) assessment may be helpful as well as cost-effective. This policy screens out some unnecessary instrumentation, without increasing the rate of complications. As emergency physicians remove the majority of foreign bodies, their expanded involvement on an ambulatory basis is both reasonable and feasible. (Hong Kong j.emerg.med. 2002;9:126-130)

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Section: Discussionmentioning

confidence: 98%

Management of Foreign Bodies in Throat: An Emergency Department's Perspective

Chiu¹,

Chung²

2002

Hong Kong Journal of Emergency Medicine

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“…Ingestion and impaction of a foreign body (FB) is a common reason for an acute presentation to hospital [1]. Whilst children account for up to 80% of foreign body ingestion or impaction [2], the most commonly ingested foreign bodies in adults are fish bones [3].…”

Section: Introductionmentioning

confidence: 99%

“…Literature from the early 1990s reported varying degrees of accuracy with which a lateral soft tissue neck radiograph could reliably be used to diagnose an impacted fish bone [1]. Sundgren et al [4] suggested that 71% of bones were missed on X-ray, while Singh et al [3] found 48% of fish bones to be radiolucent and therefore potentially non-diagnostic.…”

Section: Introductionmentioning

confidence: 99%

“…It is when impaction occurs at less common sites, such as at the cricopharyngeus or cervical oesophagus that radiological investigation has a role to play. It is in this location that impaction most often leads to perforation [1]. Furthermore, in this location symptoms and signs are often unreliable and clinical examination can be challenging.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, in this location symptoms and signs are often unreliable and clinical examination can be challenging. It is here that a radiologically assisted diagnosis is required early in order to avoid potentially fatal complications such as oesophageal perforation, retropharyngeal abscess formation, peri-oesophagitis, mediastinitis or vascular fistula formation [1]. Evans et al called for the complete abandonment of the lateral neck radiograph in assessing for the presence of impacted fish bones [6].…”

Section: Introductionmentioning

confidence: 99%

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The lateral neck radiograph for an impacted fish bone in the aero-digestive tract: Going back to basics

Shetty¹,

Gay²

2012

JBiSE

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Aim: To evaluate the radio-opacity of fish bones from a number of species using digital radiography in order to establish whether advances in acquisition and interpretative techniques have affected the radiologist's ability to detect impacted fish bones. Methods: The bones from six species of fish commonly consumed in the United Kingdom were radiographed using a soft tissue neck phantom by means of a digital radiographic X-ray tube. The images were looked at by 15 radiology consultants and registrars who determined whether the bones were visible or not using General Electric (GE) PACS workstations. Results: The radiographed bones from all six species of fish were visible by all 15 (100%) radiology registrars and consultants. Conclusion: Digital radiogramphy and modern PACS workstations have meant that fish bones can be visualized irrespective of species. The lateral neck radiograph therefore may still have an important role in the investigation of impacted fish bones in the aerodigestive tract.

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