The usefulness of computed tomography in the diagnosis of impacted fish bones in the oesophagus

Watanabe, Ken Ichi; Kikuchi, Toshihiko; Katori, Yukio; Fujiwara, Hiroko; Sugita, Reiji; Takasaka, Tomonori; Hashimoto, Sho

doi:10.1017/s0022215100140460

Cited by 72 publications

(50 citation statements)

References 10 publications

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“…Radiological opacity is not uniform even within one species. (11,12,13) This is also observed in the study of Evans et al, Watanae et al, Eli and Palme. (14) According to Palme, they detected 25 to 55% cases of fish bones in X-ray.…”

Section: Discussionsupporting

confidence: 80%

A Clinical Study of Foreign Bodies of Oesophagus and Their Management

P¹,

Sabin²,

S³

2015

jebmh

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INTRODUCTION:A foreign body is an endogenous or exogenous substance incongruous with the anatomy of the site where it is found. Foreign body ingestion can affect persons of any age. Despite major advances in diagnostic and therapeutic modalities, foreign body ingestion still causes significant dilemmas in the diagnosis and treatment. Multiple factors play role in the lodgment of these foreign bodies in the food passage. They are diet factor, dental factor, and inebriation and age factors to name a few. Preexisting strictures of esophagus is another local cause of impaction of F.B. The signs and symptoms of foreign body ingestion are quite diverse and often very non-specific. They include complete esophageal obstruction with overflow of secretions and aspiration, to mild odynophagia or dysphagia. Esophageal foreign bodies are most frequently located at the narrowest portion of the esophagus, the level of the crico-Pharynx sphincter. Rarely serious complications of such as mediastinitis, Pneumothorax, plural effusion, lung or mediastinal abscess, or massive hemorrhage due to a vascular fistula may occur before a thorough investigation is launched. Digital X-rays in two dimensions are useful in the diagnosis. CT scanning and MRI are rarely used in the evaluation of foreign bodies in the aero digestive tract, but are indicated in the event that the object is not found during endoscopic examination and migration from the airway or esophagus is suspected. In 1936 Chevalier Jackson described endoscopic techniques for the removal of foreign bodies. Since then this has remained the safest and most trusted method of treatment. Techniques for foreign body removal employing fiber optic endoscopes have been described. The treatment of choice for foreign bodies of the upper aero digestive tract is reasonably prompt endoscopic retrieval in the operating suite under anesthesia. Endoscopy is performed as an emergency in case ingestion of disc batteries with esophageal lodging and signs or symptoms of esophageal perforation to avoid further complications and strictures. AIM: To evaluate the sensitivity and specificity of digital Xray in detecting all foreign bodies impacted in throat and esophagus. To assess the factors leading to false positive findings in Digital X-rays in the study subjects; to evaluate the role of digital X-ray in detecting complications. MATERIALS AND MEHODS: 208 patients attending Government Hospital of Kozhikode with history of foreign body ingestion are included in the study. Thorough history taking, clinical examination followed by radiography with the help of Digital X-rays to locate the foreign body is done. Fish bones being common in this part of Kerala, emphasize is made to find the specificity and sensitivity of using digital X-rays in locating fish bones in food passage. Conservative management in patients showing minimal symptoms is studied. The incidence of Complications among the patients is studied. OBSERVATIONS: The sensitivity of digital X-ray in detecting fish bone foreign bodies i...

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Section: Discussionsupporting

confidence: 80%

A Clinical Study of Foreign Bodies of Oesophagus and Their Management

P¹,

Sabin²,

S³

2015

jebmh

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“…Certain reports have demonstrated the usefulness of CT for detecting impacted fi sh bones in the esophagus with a sensitivity of 90.9%-100% and specifi city of 100% using CT images taken at thin intervals. 1,5,8 Moreover, CT not only confi rms the existence and location of any impacted fi sh bones, it enables visualization of any resulting damage to neighboring structures. 5 Generally, patients with sharp objects lodged in the esophagus require urgent endoscopic intervention.…”

Section: Discussionmentioning

confidence: 99%

“…1 Esophageal foreign body impaction usually presents acutely, especially in adults, who normally have a clear history of ingestion. Adult patients may have diffuse chest pain, pressure, a vague foreign body sensation, a sensation of choking, or neck or throat pain.…”

Section: Introductionmentioning

confidence: 99%

Unusual presentation of an esophageal foreign body granuloma caused by a fish bone: usefulness of multidetector computed tomography

et al. 2011

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A 68-year-old woman had throat pain while eating fish. The pain gradually disappeared with no treatment. She visited her doctor for a medical checkup 1 year later, and an esophageal tumor was suspected. A double-contrast esophagogram revealed luminal stenosis with a mass-like defect in the middle esophagus. Esophagogastroduodenoscopy (EGD) showed smooth-surface stenosis with a retracted fold. Endoscopic ultrasonography (EUS) showed a hypoechoic mass in the submucosal layer and a well-defined linear hyperechoic structure forming a posterior acoustic shadow within the mass. A computed tomography (CT) examination was then performed using an Aquilion 64-detector row CT scanner, and a high attenuation linear structure was found in the lesion that was visualized as a fish bone-like structure on reconstructed CT images. Endoscopic removal of the fish bone was impossible, and a surgical operation would have been too invasive for a lesion suspected of being benign. The patient had no complaint related to the esophageal lesion itself and no sign of gastrointestinal tract complications. Accordingly, regular follow-up was recommended for the esophageal lesion. Follow-up examination including EGD, esophagography, and CT performed 1 year later showed that the lesion had decreased in size with no fish bone-like structure.

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“…Thus, physicians should not rely on this modality alone to either confirm or rule out any suspected fish bone impaction (8). Persistence of symptoms is an indication for CT scan as it may become a reliable adjunct tool, whereby in a retrospective Japanese series reported the sensitivity for a CT to pick up the FB was 100%, as compared to the 44% for plain films (9). In certain cases, they can get embedded into the esophageal wall and cause persistent odynophagia.…”

Section: Introductionmentioning

confidence: 99%

A Piercing Fish Bone Through Tracheal Wall

Mohamad

Ahmad

Mohamad

2018

Int. J. Hum. Health Sci.

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Fish bone ingestion is a common encounter in otorhinolaryngology setting. The patient usually present with foreign body sensation and odynophagia. Owing to its sharp end in nature, migration to the surrounding structures such as thyroid gland and neck muscles and have been reported. However the migration into the trachea is an extremely rare occurrence. We present a patient with fish bone ingestion which pierced into the trachea wall which was successfully removed via bronchoscopy.

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The usefulness of computed tomography in the diagnosis of impacted fish bones in the oesophagus

Cited by 72 publications

References 10 publications

A Clinical Study of Foreign Bodies of Oesophagus and Their Management

A Clinical Study of Foreign Bodies of Oesophagus and Their Management

Unusual presentation of an esophageal foreign body granuloma caused by a fish bone: usefulness of multidetector computed tomography

A Piercing Fish Bone Through Tracheal Wall

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