Migrating foreign bodies in the upper aerodigestive tract: a surgical challenge

Abstract

Migrating foreign bodies in the aerodigestive tract are uncommon but can pose serious complications. Long-standing migrating foreign bodies can exist manifesting chronic and unusual symptoms such as chronic cough, recurrent episodes of dyspnoea and fever. Adverse body reactions to foreign objects such as adhesions can cause difficulty in their diagnosis, localisation and removal. A thorough clinical and radiographical approach is of immense value in such cases. We report two difficult cases of migrated foreign bodies: a 2-year-old child with a long-standing foreign body that migrated to the upper mediastinum, and an adult patient with a fish bone that migrated to the oropharyngeal muscles. Presentations of these cases were not alike, with chronic unusual recurrent symptoms in one and typical acute symptoms in the other. The diagnosis and precise localisation of both foreign bodies was challenging, and an open approach was employed to remove them.

Extraluminal migration of fish bone to the thyroid gland

“…Seven-point three percent of major complications occurred in oesophageal FB and the risk of complications increases 14 times when the FB is impacted for more than 24 hours (6) . Although in our case the FB was removed more than 24 hours after initial ingestion, no major complications such as injury to vessels, neck abscess, oesophageal perforation or mediastinitis occurred (1,(6)(7)(8)(9)(10) .…”

A Case of Hidden Foreign Body: How We did It?

“…6 Delay in diagnosing and managing these conditions can result in life-threatening complications, such as abscess of neck, mediastinitis and also damage to the great vessels. 7 Removal of migratory foreign bodies is surgically challenging, hence early intervention and management should be planned. For immediate and accurate diagnosis of impacted foreign body, plain radiograph of neck is very useful.…”