Migrating fish bone piercing the common carotid artery, thyroid gland and causing deep neck abscess

Abstract

Foreign body (FB) ingestion is very common in Malaysian population. The most commonly ingested FB is fish bone. Common presenting symptoms include FB sensation, odynophagia and or sharp pricking pain during swallowing. A careful history and physical examination is very important. Despite negative laryngoscopy and rigid esophagoscopy, persistent symptoms warrants further radiographic imaging studies. The FB can migrate extraluminally and involve other important adjacent structures of the neck and along the digestive tract. We report 3 cases of extraluminal migration of fish bone and their complications, which were successfully managed. One case with vascular complication which involve common carotid artery and the other two cases with neck abscess formation involving thyroid gland, retropharyngeal and parapharyngeal abscess.

Migratory Fish Bone in the Thyroid Gland: Case Report and Literature Review

“…This size fish bone has thin sharp end and has enough hardness to penetrate the cervical esophagus wall. The fish bone migration to thyroid gland is also attributed to several other factors, such as the orientation of fish bone, contraction of the cricopharyngeus muscle during swallowing, contraction, and relaxation of the neck muscles during neck movement, and local inflammation of the esophageal or pharyngeal wall and direct pressure necrosis [ 5 ]. In all of 18 cases, 13 cases had the fish bone embedded in the left thyroid gland, while only 5 cases in the right thyroid gland.…”

“…However, due to the long history, we could not obtain the original text and abstract of this case, and the clinical data comes from Hohman's literature [ 4 ]. We reviewed 17 cases reported in the literature and the present case ( Table 1 ) [ 3 , 5 – 19 ].…”

Neck trauma: migrate foreign body

“…Travmanın şiddetine bağlı olarak derin boyun apseleri, vasküler-özefageal fistül, Taş ve ark. / Boyun travması: migrate yabancı cisim brankiyal pleksus hasarlanması ve tromboembolizm görülebilir [2,3].…”

Fish bone ingestion presenting to a local institution in Singapore

“…This is in view of the potential for serious complications, such as perforation of the oesophagus and the stomach that may result in abscess formation or adjacent vascular injury. (11) Retrieval options include direct laryngoscopy, rigid oesophagoscopy or flexible OGD, depending on the location where the fish bone is impacted. Fig.…”