Neck abscess and vocal cord paresis: delayed complications of a self-extruded long fishbone stuck in throat

Vallamkondu, Vamsidhar; Carlile, Simon R.; Shakeel, Muhammad; Ah‐See, Kim

doi:10.1136/bcr-2013-201832

Cited by 7 publications

(10 citation statements)

References 9 publications

(7 reference statements)

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“…Other complications include recurrent deep neck infection for 2 years, penetration of the facial artery, haematoma of the floor of the mouth and a retropharyngeal abscess 6. Neck abscess has been reported following self-extrusion of a fish bone 7. Neck space infection has also been reported following migration but no significant sequalae occurred once the fish bone had been removed surgically 8.…”

Section: Discussionmentioning

confidence: 99%

A migratory shark bone

Mathew

Myuran²,

Ching

2018

BMJ Case Reports

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Fish bone ingestion is a common presentation in ENT. If not managed correctly, it can cause serious complications for the patient and dilemmas for the clinician. A 49-year-old Sri Lankan woman presented to the emergency department following shark bone ingestion with a 'pricking' sensation in her throat. After initial investigation, the bone migrated through to the sternocleidomastoid muscle. After surgical removal of the shark bone she went on to develop a large neck collection, which required surgical drainage. The careful attention to the patient's history and use of imaging facilitated treatment in this case of fish bone ingestion and management of the sequelae.

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Section: Discussionmentioning

confidence: 99%

A migratory shark bone

Mathew

Myuran²,

Ching

2018

BMJ Case Reports

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“…In the literature, a number of complications related to fishbone were ever reported, including vocal cord paresis, [5] hepatic abscess, [6] aortic-oesophageal fistula, subclavian oesophageal fistula and carotid rupture, [5] subclavian artery pseudoaneurysm, [7] aortic pseudo-aneurys, [8] false esohageal hiatus hernia, [9] and pharyngeal perforation. [10,11] In addition, fish bone injury may also cause retropharyngeal abscess, which may further lead to cervical SEA, [12–15] or even brain abscess [14] (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Thoracic spinal epidural abscess caused by fishbone perforation

Chen

Wang²,

Ni³

2016

Medicine

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Rationale:Ingestion of a fishbone is a common cause of esophageal injury, but spinal epidural abscess (SEA) is a rare condition due to the esophageal penetration by a swallowed fishbone. Prompt diagnosis can be seldom made owing to incomplete patient history taking and difficulties in imaging evidence identification.Patient concerns:We describe the case of a 62-year-old woman who was stuck in her throat by a fishbone, and complained of back pain, paresis of the lower limbs and fever, successively. To our knowledge, this is the first case report that we know of thoracic SEA caused by fishbone perforation.Diagnoses:About 20 days after the onset of severe back pain, she was diagnosed with SEA based on the clinical presentation and imaging findings.Interventions:Antibiotic therapy and rehabilitation therapy were carried out afterwards. However, due to exacerbation of her condition, surgical intervention had to be taken eventually.Outcomes:It is quite unfortunate for this patient to have a poor prognosis due to a delayed diagnosis and an improper management.Lessons:A number of lessons can be learnt from this case.

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“…[1][2][3] Muscle contraction, horizontal orientation, patient manipulation, and tissue reaction may contribute to the migration. [1][2][3][4][5][6][7][8][9] These migrating foreign bodies are rare; however, they may cause severe complications such as penetration of vessels, deep neck infection, esophageal perforation, retropharyngeal abscess, and thyroid abscess. 2,3,5,7,[9][10][11][12][13][14][15] Immediate diagnosis, visualization, and removal of migrating foreign bodies on endoscopy under local anesthesia can be very difficult.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9] These migrating foreign bodies are rare; however, they may cause severe complications such as penetration of vessels, deep neck infection, esophageal perforation, retropharyngeal abscess, and thyroid abscess. 2,3,5,7,[9][10][11][12][13][14][15] Immediate diagnosis, visualization, and removal of migrating foreign bodies on endoscopy under local anesthesia can be very difficult. [3][4][5]10,11,14 In addition, some cases presented with subtle or bizarre manifestations such as cervical mass or cutaneous fistula without oropharyngeal complaints.…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5]10,11,14 In addition, some cases presented with subtle or bizarre manifestations such as cervical mass or cutaneous fistula without oropharyngeal complaints. [5][6][7][8]10,16,17 There are several techniques to retrieve a migrating foreign body in the neck, including the endoscopic and percutaneous approaches. The aim of our report is to describe these procedures with 2 unusual cases, review literature, and propose an algorithm to determine the initial surgical management of migrating ingested foreign bodies.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Approaches to Migrating Ingested Foreign Bodies in the Neck

Chang

Wang

2020

Ear Nose Throat J

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This report presents 2 unusual cases along with a review of the current literature. Further, it aims to propose an algorithm for the initial surgical management of migrating ingested foreign bodies, focusing on the use of fluoroscopy, rigid laryngopharyngoscopy, and an external surgical approach. A 42-year-old man presented with progressive odynophagia after swallowing a fish bone 20 days previously, and a 60-year-old woman presented with a painful enlarging mass over the left lower neck for 1 month. The first case involved a horizontally oriented pharyngeal fish bone with a portion in the neck, which was removed under fluoroscopic guidance and rigid laryngopharyngoscopy in succession. In the second case, there was an extraluminal fish bone that had migrated into the sternocleidomastoid muscle, which was retrieved through cervical incision. All foreign bodies were removed without complications. To the best of our knowledge, this is the second report of fluoroscopy-guided ingested foreign body retrieval and the first one with a proposed algorithm for the management of migrating ingested foreign body in the neck. The location and orientation of migrating ingested foreign bodies as well as their relation to structures in the neck are important factors in determining the surgical approach.

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Neck abscess and vocal cord paresis: delayed complications of a self-extruded long fishbone stuck in throat

Cited by 7 publications

References 9 publications

A migratory shark bone

A migratory shark bone

Thoracic spinal epidural abscess caused by fishbone perforation

Clinical Approaches to Migrating Ingested Foreign Bodies in the Neck

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