Migration of ingested sharp foreign body into the bronchus: a case report and review of the literature

Abstract

Background Foreign body ingestion is a common emergence in gastroenterology. Foreign bodies are most likely to be embedded in the esophagus. The sharp ones may penetrate the esophageal wall and lead to serious complications. Case presentation A 72-year-old Chinese female was admitted to our hospital with a 4-day history of retrosternal pain and a growing cough after eating fish. Chest computed tomography scan indicated that a high-density foreign body (a fish bone) penetrated through the esophageal wall and inserted into the left main bronchus. First, we used a rigid esophagoscope to explore the esophagus under general anesthesia. However, the foreign body was invisible in the side of the esophagus. Then, the fiberoptic bronchoscopy was performed. We divided the fish bone, which traversed the left main bronchus, into two segments under holmium laser and removed the foreign body successfully. The operation time was short and there were no complications. The patient was discharged 1 week postoperatively and was symptom free even under a liquid diet. Conclusions There are several challenges in the management of this rare condition. We applied the technique of interventional bronchoscopy to the management of esophageal foreign body flexibly in an emergency. A surgery was avoided, which was more invasive and costly.

Varied Manifestations of Sharp Penetrating Foreign Bodies in the Aerodigestive Tract: Our Experience

“…This was similar to a study conducted by Hajiioannou et al, wherein there was an iatrogenic migration of an impacted pharyngeal foreign body of the hypopharynx to the pre-vertebral space [ 6 ]. Another study published by Qiu et al showed similar migration of ingested sharp foreign body into the bronchus [ 7 ].…”

Esophageal foreign body removal under holmium laser-assisted gastroscope: A case report

“…Moreover, the holmium laser is still of high security as a great amount of the energy can be absorbed by water and the penetration depth is no more than 0.5 mm, enabling the surrounding tissues to get mild injuries only. In a previous case, a fishbone punctured the bronchus through the esophagus and was removed successfully after being broken by holmium laser bronchoscopically ( 8 ). This demonstrates that it is feasible and effective to break the incarcerated foreign body with holmium laser and then remove it endoscopically.…”