A case of migratory fish bone in the thyroid gland

Masuda, Mitsuharu; Honda, Tatsuya; Hayashida, Momoko; Samejima, Yasuhiro; Yumoto, Eiji

doi:10.1016/j.anl.2005.09.013

Cited by 33 publications

(16 citation statements)

References 4 publications

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“…In our patient, we identified the foreign object by using intraoperative ultrasonography, as well as preoperative assessment, avoiding the risk of accidental bleeding or tissue damage that may be caused by blind exploration. Unexpectedly, there are only a few reports on the use of ultrasonography for the localization of foreign bodies in the head and neck region (Ng et al 2003;Masuda et al 2006), although it is widely recognized to be a safe, quick and cheap technique, and additionally offers the remarkable ability of real-time imaging. Neck exploration for migrated foreign bodies has been described by some authors as "searching for a needle in a haystack" (Sreetharan et al 2005), or "fishing for a needle in the deep ocean" (Tang et al 2009); therefore it is imperative to use adequate preoperative assessment and effective imaging during the operation.…”

Section: Discussionmentioning

confidence: 99%

“…The extraluminal migration of fish bones in the upper digestive tract has been reported only rarely, and it is even more unlikely that the foreign body will remain in the neck for a prolonged period. In addition, although neck exploration for migrated foreign bodies is a difficult procedure, there are a few studies used intraoperative ultrasonography in the head and neck region (Ng et al 2003;Masuda et al 2006). We report the rare case of a migratory fish bone that remained asymptomatic in the neck for 9 months before its removal, and include a review of the related literature.…”

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The Prolonged Presence of a Fish Bone in the Neck

Watanabe

Amano

Nakanome

et al. 2012

Tohoku J. Exp. Med.

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Fish bones are one of the most frequently observed ingested foreign bodies in the pharynx-esophagus. Fish bones have a tendency to stick and penetrate the mucosa, which can occasionally lead to severe or lethal complications. The extraluminal migration of fish bones in the upper digestive tract is a rare event, and it is even more unlikely that the foreign body will remain in the neck for a prolonged period. We report the unique case of a 69-year-old woman who remained asymptomatic, while a fish bone was lodged in her neck for 9 months. Finally, after her anterior neck had become swollen, she underwent neck exploration, which revealed that the fish bone was embedded in the scar tissue running from within the thyroid gland to outside of the thyroid. Treatment proceeded without complications, and the foreign body was removed successfully. The length of the fish bone was 34 mm. Intraoperative ultrasonography was able to identify the fish bone in situ using real-time imaging; therefore, we recommend this technique for locating migrated foreign bodies in the neck. Ingested fish bones are one of the most frequently observed foreign bodies in the pharynx-esophagus (Remsen et al. 1983;Loh et al. 2000;Athanassiadi et al. 2002); particularly in East Asia, a whole fish is often served without removing its bones. Owing to their fine, linear, and sharp structure, fish bones have a tendency to stick and penetrate the mucosa, which can occasionally lead to severe or lethal complications. The extraluminal migration of fish bones in the upper digestive tract has been reported only rarely, and it is even more unlikely that the foreign body will remain in the neck for a prolonged period. In addition, although neck exploration for migrated foreign bodies is a difficult procedure, there are a few studies used intraoperative ultrasonography in the head and neck region (Ng et al. 2003;Masuda et al. 2006). We report the rare case of a migratory fish bone that remained asymptomatic in the neck for 9 months before its removal, and include a review of the related literature. Clinical ReportA 69-year old woman was referred to our institution with an enlarged anterior neck. Local neck symptoms had worsened compared with those a few days before presentation. A computed tomography (CT) scan revealed a softtissue shadow of increased density, and a fine linear radiopaque object was found located in the right neck region. The patient remembered that a fish rib bone had stuck in her throat while she was eating a grilled fish (a horse mackerel) 9 months ago, although she had been asymptomatic until the present time.Physical examination revealed skin flare and swelling on the anterior neck across a region that was approximately 60 mm in diameter, and the center part of the involved area had an eroded surface with easy bleeding. No fever was present and the patient did not report tenderness in the affected region. No abnormal findings were found in any other region of the head and neck. A blood examination revealed slightly increased levels of white...

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

The Prolonged Presence of a Fish Bone in the Neck

Watanabe

Amano

Nakanome

et al. 2012

Tohoku J. Exp. Med.

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“…The needle was only identified on posteroanterior and lateral soft tissue cervical spine radiographs. Chicken and fish bones can often be missed on plain films especially when the bone is lodged in an area of high soft tissue overlap [3], and sometimes they are radiolucent. Hence, if clinical findings are negative, there is a temptation to discharge the patient, especially if their symptoms are mild and nonspecific but the consequences of missing a foreign body are potentially life-threatening.…”

Section: Discussionmentioning

confidence: 99%

The Eye in the Neck: Removal of a Sewing Needle from the Posterior Pharyngeal Wall

Unadkat

Talwar

Tolley

2010

Case Reports in Medicine

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Foreign body ingestion is a frequent presenting complaint to most emergency departments but the finding of a sewing needle in the posterior pharynx particularly is a rare finding. We report a case of a male patient with a sewing needle lodged in the posterior pharynx despite a history suggestive of chicken bone ingestion, absent clinical features, and negative flexible endoscopic examination. The needle was only identified through cervical spine radiographs. Even subsequent pharyngoscopy, laryngoscopy, and upper oesophagoscopy all proved to be unremarkable with the patient eventually requiring a left neck exploration to remove the needle. The case outlines the importance of simple radiography in suspected foreign body ingestion, even though clinical and endoscopic findings may be unremarkable.

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“…Most of the foreign bodies were reported to be lodged in the pharynx, esophagus, stomach, and duodenum. A fish bone has the ability to migrate to the thyroid gland, carotid artery, mediastinum, or subcutaneous tissue due to the constant contraction and relaxation of the pharyngeal musculature, esophageal peristalsis, and surrounding tissue reactions 6–9…”

Section: Discussionmentioning

confidence: 99%

Migration of foreign body from postcricoid region to the subcutaneous tissue of the neck

Shaariyah

Husain

Dipak

et al. 2010

Annals of Saudi Medicine

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Migration of a foreign body from the hypopharynx to the subcutaneous tissue of the neck is a rare event. We report a case of a 48-year-old male who accidentally swallowed a fish bone which was not identified intraoperatively. The patient then presented with migration of the bone to the soft tissue of the neck. We conclude that careful assessment of the patient with a foreign body in the throat is crucial to avoid fatal complications.

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A case of migratory fish bone in the thyroid gland

Cited by 33 publications

References 4 publications

The Prolonged Presence of a Fish Bone in the Neck

The Prolonged Presence of a Fish Bone in the Neck

The Eye in the Neck: Removal of a Sewing Needle from the Posterior Pharyngeal Wall

Migration of foreign body from postcricoid region to the subcutaneous tissue of the neck

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