Usefulness of Ultralow-Dose (Submillisievert) Chest CT Using Iterative Reconstruction for Initial Evaluation of Sharp Fish Bone Esophageal Foreign Body

Kim, Eun Young; Min, Young Gi; Bista, Anjali Basnyat; Park, Kyung Joo; Kang, Doo Kyoung; Sun, Joo Sung

doi:10.2214/ajr.15.14353

Cited by 14 publications

(13 citation statements)

References 34 publications

(29 reference statements)

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“…In this case, the patient was admitted to the emergency room six days after ingesting a chicken bone that had caused the perforation of his esophagus and mediastinitis. As this case demonstrates, early removal of FBs is necessary to prevent the development of mediastinitis [3,4,5]. Any degree of sore throat, dysphagia, odynophagia, difficulty breathing, and vomiting are common symptoms in esophageal FB diseases.…”

Section: Discussionmentioning

confidence: 91%

“…FB sensation and localized pain are some patients' main complaints in the early periods of such diseases. As the disease progresses or complications develop, localized inflammatory or systemic symptoms, such as swelling of the neck, hematemesis, dysphagia, dyspnea, fever, and chest pain can occur [5,6]. FBs in the alimentary tract should be evaluated carefully to identify their exact anatomic location [2].…”

Section: Discussionmentioning

confidence: 99%

“…The most common esophageal FB diseases in adults are caused by impacted meat or other food. Fish bones in particular have been known to cause EP in many countries [1,2,4,5]. Cases of spontaneous and iatrogenic ruptures have also been observed.…”

Section: Introductionmentioning

confidence: 99%

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Esophagial Perforation Due to Chicken Bone Ingestion: Multidetector CT Findings

2017

Ann Clin Anal Med

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ÖzYabancı cisim impaksiyonuna bağlı gelişen özefagus perforasyonunda hayatı tehdit edici komplikasyonların önlenebilmesi için erken tanı ve tedavi önemlidir. Eriş-kinlerde genelde perforasyon sebebi et, balık ve tavuk kemikleridir. Boğaz ağrısı, disfaji ve kusma sık görülen semptomlardır, ancak perforasyon eşlik ederse medastinit gibi ciddi komplikasyonlar gelişebilir. 52 yaşında erkek hasta, 6 gün önce tavuk eti yedikten sonra ortaya çıkan boğaz ağrısı ve disfaji şikayetleriyle acil servise başvurdu. Toraks bilgisayarlı tomografisinde (BT)tavuk lades kemiğine ait Y şeklinde yabancı cisim gözlendi. Çok kesitli BT ile özefagus perforasyona bağlı mediastinal hava ve sıvı koleksiyonu gibi mediastinit bulguları da saptandı. Öze-fagustaki yabancı cisimler ve bunlara bağlı komplikasyonları göstermede çok kesitli BT önemli bir rol oynar. Anahtar KelimelerYabancı Cisimler; Özofagus Perforasyonu; Mediastinit; Çok Kesitli Bilgisayarlı Tomografi Abstract Esophageal perforation (EP) due to foreign body impaction requires early diagnosis and treatment in order to prevent life-threatening complications. EP in adults is most frequently caused by the impaction of meat, fish, and chicken bones. The common symptoms are sore throat, dysphagia, and vomiting, but in the presence of perforation, mediastinitis and other complications can occur. In our case, a 52-year-old man was admitted to the emergency room with a six-day history of sore throat and dysphagia after eating chicken. Computed tomographyof the thorax revealed a Y-shaped foreign body resembling the wishbone of a chicken. Mediastinal air secondary to esophageal perforation and further evidence of mediastinitis were also discovered with multidetector computed tomography (MDCT). This case shows that MDCT plays an important role in detecting esophageal foreign bodies and their complications.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Esophagial Perforation Due to Chicken Bone Ingestion: Multidetector CT Findings

2017

Ann Clin Anal Med

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“…Our patient did not complain of any symptoms, including dysphagia, odynophagia, hematemesis, dyspnea, etc. CT has a sensitivity of 90%-100% in detecting impacted fish bones[ 9 - 11 ], which is obviously superior to 32% by plain radiography[ 6 ]. However, in the present case, both plain radiography and CT did not identify the impacted fish bone.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of delayed cervical infection and incomplete quadriplegia with fish-bone ingestion: A case report

Li¹,

Miao²,

Cheng³

et al. 2021

WJCC

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BACKGROUND The most commonly ingested foreign body in Asians is fish bone. The vast majority of patients have obvious symptoms and can be timely diagnosed and treated. Cases of pyogenic cervical spondylitis and diskitis with retropharyngeal and epidural abscess resulting in incomplete quadriplegia due to foreign body ingestion have been rarely reported. The absence of pharyngeal or esophageal discomfort and negative computed tomography (CT) findings of fish bone have not been reported. We report the case of an elderly female patient with delayed cervical infection and incomplete quadriplegia who had a history of fish bone ingestion. CASE SUMMARY A 73-year-old woman presented with right neck pain and weakness of four limbs for a week, and had a history of fish bone ingestion and negative findings on laryngoscopic examination one month previously. She did not complain of any pharyngeal or esophageal discomfort. Cervical magnetic resonance imaging showed C4/C5 spondylitis and diskitis along with retropharyngeal and ventral epidural abscesses. No sign of fish bone was detected on lateral cervical radiography and CT scans . The muscle strength of the patient’s right lower limb receded to grade 1 and other limbs to grade 2 suddenly on the 10th day of hospitalization. Emergency surgery was performed to drain the abscess and decompress the spinal cord by removing the anterior inflammatory necrotic tissue. Simultaneously, flexible esophagogastroduodenoscopy was carried out and a hole in the posterior pharyngeal wall was found. The motor weakness of the right lower limb improved to grade 3 and the other limbs to grade 4 within 2 d postoperatively. CONCLUSION This rare case highlights the awareness of the posterior pharyngeal or esophageal wall perforation in patients with cervical pyogenic spondylitis along with a history of fish bone ingestion, even though local discomfort symptoms are absent and the radiological examinations are negative.

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“…This imaging modality demonstrated 100% sensitivity and 97.8% specificity rates, thus allowing to keep a high image quality, while reducing the radiation dose. 23 Another novel approach is the use of 64-slice multi-detector CT scan, providing twice the sensitivity in comparison to plain radiography (100 and 51.7%, respectively). 24…”

Section: Review Of the Literaturementioning

confidence: 99%

Fish Bone Foreign Body: The Role of Imaging

Klein

Tamir

Marom

et al. 2018

Int Arch Otorhinolaryngol

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Introduction Fish bone foreign body (FFB) impaction in the upper aerodigestive tract is a common cause for emergency department referral. Its management varies in both diagnosis and treatment paradigms. Fish bone foreign bodies are more commonly found in the oropharynx in cases of patients < 40 years old, and in the esophagus in cases of patients > 40 years old. Symptoms are typically non-indicative for the location of the FFB, with the exception of foreign body sensation at/superior to the cervical esophagus. A lack of findings during the physical examination is routinely followed by imaging, with computed tomography (CT) being the preferred modality. In practice, many patients undergo unnecessary imaging studies, including CT scans. Objectives To identify patients with suspected fish bone impaction who do not require CT imaging and can be safely discharged. Data Synthesis We have searched the PubMed database for the following medical subject headings (MeSH) terms: fish bone , fish foreign body AND oropharynx , hypopharynx , esophagus , flexible esophagoscopy , and rigid esophagoscopy . Our search in the English language yielded 32 papers. Case reports were included, since they highlighted rare and serious complications. Conclusion In patients > 40 years old suspected of fish bone impaction, non-contrast CT is recommended and should be urgently performed, even in the presence of ambiguous symptoms. However, in patients < 40 years old presenting within 24 hours from ingestion, imaging has little diagnostic value due to the low probability of esophageal fish bones. For this specific subgroup, in the absence of clinical findings, discharge without imaging studies may be considered safe.

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Usefulness of Ultralow-Dose (Submillisievert) Chest CT Using Iterative Reconstruction for Initial Evaluation of Sharp Fish Bone Esophageal Foreign Body

Cited by 14 publications

References 34 publications

Esophagial Perforation Due to Chicken Bone Ingestion: Multidetector CT Findings

Esophagial Perforation Due to Chicken Bone Ingestion: Multidetector CT Findings

Surgical treatment of delayed cervical infection and incomplete quadriplegia with fish-bone ingestion: A case report

Fish Bone Foreign Body: The Role of Imaging

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