Live Fish Impaction in Hypopharynx in an Elderly Patient

Abstract

s u m m a r y Successful removal of a live fish impacted in the hypopharynx of a 65-year-old male is reported to emphasize the importance of the speed with which it has to be recognized and intervened. The present report also highlights the altered sensory perception in the oral cavity of elderly people as a potential risk factor for airway obstruction due to a foreign body. Moreover, the possibility of a foreign body has to be suspected, if an elderly patient without any cardiorespiratory illness presents with an acute onset of progressive respiratory distress.

An Impacted Live Fish in the Oropharynx of an 8-year old Child

“…Oral examination revealed a large fish obstructing the entire oropharynx. Impaction of live fish in the laryngopharynx has been previously reported in adults and in children, 4,5 but to the best of our knowledge not in our institution.…”

“…However, live fish impaction in the hypopharynx in both children and adults have been reported elsewhere. 4,5 Most notable was the report of a live fish successfully removed in toto from the hypopharynx of a 7-month-old child. 4 Removal was done under general anesthesia inside the operating room.…”

Whole fish an unusual foreign body in the tongue of a child

“…On the other hand, foreign body ingestion and impact in the oropharynx are rarely reported since they are easily seen and removed by a finger swap method or by using Magill's forceps. [ 3 4 5 ] Whole fish impact in the tongue is very uncommon presentation in children. However, it is possible in adults of fisherman family due to the habit of keeping it in between the teeth while fishing, and in older children of same family putting it in the mouth of younger children while playing.…”

“…Dislodgment during difficult removal can cause complete airway obstruction and requires urgent securing of the airway by surgical methods. [ 5 ]…”

“…Subramanian et al . [ 5 ] made an attempt to remove impacted fish by Magill's forceps from diminished sensory perception of the pharynx of an elderly patient without anesthesia. They concluded that it is easy to remove fish if it enters with tail first in the mouth and difficult to remove due to presence of fins and the slippery nature of the fish and safe method to remove marine foreign bodies are by using Magill's forceps or sponge stick forceps.…”