Pharyngeal perforation by a swallowed sewing needle

An Unusual Neck Mass: Ingested Chicken Bone

BACKGROUND

Foreign bodies in the upper aerodigestive tract are frequently seen in otolaryngological practice, but migration of an ingested foreign body to the neck is a very rare condition.

CASE REPORT

We present a 66-year-old woman admitted to our outpatient department with a painful neck mass. She had a history of emergency department admission 4 months prior with odynophagia after eating chicken meal. A physical examination revealed a painful and hyperemic mass on the left neck. Antibiotherapy did not relieve the patient's symptoms and signs. A 3-cm linear foreign body was observed in X-ray and computed tomography scans. The symptoms of the patient were relieved after excision of the foreign body.

CONCLUSION

Although it is a rare situation, migration of a foreign body ingested through the aerodigestive tract to the neck should be kept in mind in the differential diagnosis of patients who present with neck masses.

Iatrogenic migration of an impacted pharyngeal foreign body of the hypopharynx to the prevertebral space

Impaction of foreign bodies in the upper aerodigestive tract is commonly encountered in ENT practice. The present paper describes an iatrogenic complication with migration of an impacted foreign body (chicken bone) of the hypopharynx into the prevertebral space, after unsuccessful attempt of endoscopic removal. The foreign body was visualized with cervical CT scan lying extraluminally between the major vessels of the neck. An open surgical procedure with neck exploration was necessary for the definite treatment.

The eye in the neck: removal of a sewing needle from the posterior pharyngeal wall

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.