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Lee JH, Kim SJ. Characteristics and outcomes of emergency department patients with a foreign body that entered through the ear, nose or mouth: a 10-year retrospective analysis. J Laryngol Otol 2021; 135:1-7. [PMID: 34674776 DOI: 10.1017/s0022215121002747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Foreign bodies in the ear, nose and throat commonly necessitate emergency department visits. METHOD This retrospective study was conducted on emergency department visits from January 2010 to December 2019 to determine characteristics and clinical prognoses of ENT patients. Patients were divided into three groups according to foreign-body entry route; patient characteristics and clinical findings were compared between groups. RESULTS Of 676 142 emergency department visits, 10 454 were because of ENT-related foreign bodies. The mean (± standard deviation) age of subjects was 24.0 (± 23.4) years, and 5176 patients were male (49.5 per cent). The most common entry route was the mouth (74.5 per cent). Most patients (97.1 per cent) were discharged after emergency treatment. Intensive care and in-hospital mortality occurred only in the mouth group. CONCLUSION Clinical findings differ depending on foreign-body entry route. After emergency treatment, most patients were discharged; some cases presented serious complications.
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Affiliation(s)
- J H Lee
- Department of Emergency Medicine, Seoul, Republic of Korea
| | - S J Kim
- Department of Otorhinolaryngology - Head and Neck Surgery, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
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2
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Abdulber Fakoury M, Abdulbaki H, Darraj E, Almohammad Alsalem F. A Case Report of Migrating Fish Bone to the Thyroid Gland. DUBAI MEDICAL JOURNAL 2020. [DOI: 10.1159/000508534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Fish bone as a foreign body in the throat is common and frequently seen in emergency departments. In most cases, the bone is stuck in the tonsils or oropharynx, some go further to the laryngopharynx, and in rare cases they may go furthest. The authors report a rare case of a fish bone that migrated to the thyroid gland.
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3
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Dhandapani S, Meher R, Wadhwa V, Chaudhary D. A Rare Case of Metallic Foreign Body in Parapharyngeal Space: Preoperative Imaging and Surgical Removal. MAMC JOURNAL OF MEDICAL SCIENCES 2019. [DOI: 10.4103/mamcjms.mamcjms_57_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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4
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Migratory Fish Bone in the Thyroid Gland: Case Report and Literature Review. Case Rep Med 2018; 2018:7345723. [PMID: 29560016 PMCID: PMC5842739 DOI: 10.1155/2018/7345723] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/16/2018] [Indexed: 11/24/2022] Open
Abstract
Introduction Foreign body stuck in the throat is a common emergency case, which can be removed by the endoscopic treatment. Fish bones are one of the common observed foreign bodies in the pharynx or cervical esophagus. Fish bones have a risk of damaging the mucosa when lodged in the upper digestive tract. Foreign bodies of fish bones located outside the laryngopharyngeal tissue are relatively unusual, and it is even more rare that they remain in the thyroid. It may cause local infection, abscess formation, large blood vessels rupture, and other serious life-threatening complications when the position of the fish bone migrates to the neck. We present a unique case of a 31-year-old woman in whom a fish bone was found in the thyroid. The fish bone had been removed successfully two months after the onset of symptoms. The relevant literature is reviewed and summarized. Case Presentation A foreign body which is located in the neck area by swallowing is usually found in the emergency case. One of the commonest foreign bodies is the fish bone. The common presenting symptoms include foreign body (FB) sensation and or a sharp pain during swallowing. But we report a rare case in which a migratory fish bone stuck in the thyroid gland was found after 3 months. We retrieved previous literature and made a summary. Conclusions Fish bones are not easy to be found as a foreign body. Surgeons should be aware that fish bones can become lodged in the thyroid gland. Combined with the history should be a wary fish bone to migrate to the case of the thyroid, to avoid misdiagnosis. To confirm the diagnosis, we can take ultrasound, computerized tomographic scanning (CT), and other tests.
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5
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Choi SA, Kim SB, Shin SY, Eun YG. Undetected metallic chopstick stabbed on neck resulting tinnitus and foreign body sensation. J Korean Neurosurg Soc 2015; 57:140-2. [PMID: 25733998 PMCID: PMC4345194 DOI: 10.3340/jkns.2015.57.2.140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 04/01/2014] [Accepted: 04/06/2014] [Indexed: 12/03/2022] Open
Abstract
Penetrating neck injuries constitute 5-10% of all trauma cases. These injuries may cause life-threatening suppurative or vascular complications, but the severity and extent of damage depends upon the inflicting object and the involved structures. If significant complications are not expected, then it is best to leave the foreign body embedded and avoid surgical risks. We present a rare case of a foreign body embedded in the neck causing tinnitus and foreign body sensation.
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Affiliation(s)
- Sun A Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Sung Bum Kim
- Department of Neurosurgery, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Seung Youp Shin
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Young Gyu Eun
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
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6
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Chen HH, Ruan LX, Zhou SH, Wang SQ. The utility of repeated computed tomography to track a foreign body penetrating the esophagus to the level of the thyroid gland. Oral Radiol 2013; 30:196-202. [PMID: 24817789 PMCID: PMC4009138 DOI: 10.1007/s11282-013-0156-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 09/25/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Foreign body (FB) ingestion is a common problem in otolaryngology. One uncommon complication of FB ingestion is penetration to the level of the thyroid gland. To our knowledge, only 21 such cases have been reported in the literature. Here, we report a case of an esophageal FB penetrating to the level of the right thyroid gland. CASE REPORT The patient was a 38-year-old woman in whom an esophageal FB penetrated to the level of the right thyroid gland. We traced the path to the thyroid gland using repeated computed tomography (CT) scans and demonstrated the importance of multiplanar reconstruction in locating the FB and formulating a precise surgical plan. CONCLUSIONS To our knowledge, this is the first report of repeat CT scans being used to demonstrate the migratory route, over time, of a FB penetrating through the esophagus to the level of the thyroid gland. Our results suggest that multiplanar reconstruction may play a key role in the precise diagnosis of a FB at the level of the thyroid gland and may help surgeons choose the best approach for removal.
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Affiliation(s)
- Hai-Hong Chen
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003 China
| | - Ling-Xiang Ruan
- Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003 China
| | - Shui-Hong Zhou
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003 China
| | - Shen-Qing Wang
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003 China
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7
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Jha SK, Kumar SP, Somu L, Ravikumar A. Missing fish bone: case report and literature review. Am J Otolaryngol 2012; 33:623-6. [PMID: 22365390 DOI: 10.1016/j.amjoto.2012.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Accepted: 01/14/2012] [Indexed: 12/18/2022]
Affiliation(s)
- Sandeep Kumar Jha
- Department of Otorhinolaryngology and Head & Neck Surgery, Chettinad Health Research Institute, Kelambakkam, Chennai 600015, Tamil Nadu, India.
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8
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Ohbuchi T, Tabata T, Nguyen KH, Ohkubo JI, Katoh A, Suzuki H. Thyroid gland cutaneous fistula secondary to a migratory fish bone: a case report. J Med Case Rep 2012; 6:140. [PMID: 22657563 PMCID: PMC3419094 DOI: 10.1186/1752-1947-6-140] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 02/29/2012] [Indexed: 11/16/2022] Open
Abstract
Introduction We report an extremely rare case of a migratory fish bone penetrating through the thyroid gland. Case presentation A 56-year-old Japanese woman presented with a two-month history of a painless cutaneous fistula in her anterior neck with pus discharge. Endoscopic examinations showed no abnormality, but computed tomography revealed a bone-density needle-shaped foreign body sticking out anteroinferior from the esophagus wall, penetrating through her left thyroid lobe and extending nearly to the anterior cervical skin. A migratory fish bone was suspected, and the foreign body was removed under general anesthetic, combined with a hemithyroidectomy. The injured esophageal mucosa was sutured and closed. Our patient’s postoperative course was uneventful, and she was allowed oral food intake seven days after the surgery. No evidence of recurrence was seen over the postoperative follow-up period of 42 weeks. Conclusion We should be aware that fish bone foreign bodies may migrate out of the upper digestive tract and lodge in the thyroid gland.
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Affiliation(s)
- Toyoaki Ohbuchi
- Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
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9
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A pharyngeal foreign body presenting as a painful neck mass. Otolaryngol Head Neck Surg 2010; 143:315-6. [PMID: 20647145 DOI: 10.1016/j.otohns.2010.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Revised: 02/23/2010] [Accepted: 03/02/2010] [Indexed: 11/24/2022]
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10
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Hohman MH, Harsha WJ, Peterson KL. Migration of Ingested Foreign Bodies into the Thyroid Gland: Literature Review and Case Report. Ann Otol Rhinol Laryngol 2010; 119:93-8. [PMID: 20336919 DOI: 10.1177/000348941011900205] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: We review the literature on the migration of ingested foreign bodies into the thyroid gland to analyze trends in patient presentation, evaluation, and management. Additionally, we present a case of an intrathyroidal foreign body from our own experience. Methods: We searched the Medline database using key words “foreign bodies” and “thyroid gland,” and present a new case report of an ingested foreign body that migrated to the thyroid gland. Results: Our search generated 11 relevant articles with 15 total patients. All patients were female; 10 foreign bodies were fish bones, 2 were chicken bones, and 3 were wire bristles. The most common presenting symptoms were throat pain (67%) and dysphagia (47%). Computed tomography was the most sensitive test (100%), although cervical radiography also had high sensitivity (79%). Endoscopy was substantially less sensitive (38%). All patients required neck exploration. Conclusions: Radiographic evaluation has a high likelihood of detecting foreign bodies in the thyroid gland, and a computed tomographic scan is doubly useful because it assists in preoperative planning. Endoscopy has limited utility in cases of extraluminal migration, but should still be performed to evaluate soft tissue that is poorly visualized on a computed tomographic scan. Unless the foreign body can be removed endoscopically and there are no complications from migration or perforation, the definitive treatment is surgical.
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Affiliation(s)
- Marc H Hohman
- Department of Otolaryngology, Virginia Mason Medical Center, Seattle, Washington, USA
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11
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Hirasaki S, Inoue A, Kubo M, Oshiro H. Esophageal large fish bone (sea bream jawbone) impaction successfully managed with endoscopy and safely excreted through the intestinal tract. Intern Med 2010; 49:995-9. [PMID: 20519815 DOI: 10.2169/internalmedicine.49.3262] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 68-year-old man consulted our hospital because of back pain. A chest computed tomography (CT) demonstrated a high-density foreign body in the esophageal wall. There was no evidence of pneumomediastinum. Endoscopic examination demonstrated a large fish bone that was stuck in the esophageal wall. It was dislodged and moved into the stomach. The bone was excreted through the intestinal tract on the seventh hospital day. Unintentional ingestion of large fish bones must be considered potentially dangerous. Complications such as esophageal perforation or mediastinitis should be confirmed by CT; and then, the esophageal foreign body should be removed as soon as possible.
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Affiliation(s)
- Shoji Hirasaki
- Division of Gastroenterology, Kubo Hospital, Imabari, Japan.
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12
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Abstract
Patients with impacted foreign bodies in the upper aerodigestive tract present commonly to ENT clinics. This case report highlights two important issues in the management of these patients. First, if the evidence of esophageal perforation is strong and contrast swallow is negative, the physician must consider further imaging, such as contrast computed tomography. Second, ENT physicians must beware of the complications of esophageal trauma, including major vascular injury and aortoesophageal fistula, in patients with retained sharp foreign bodies in the mid-esophagus.
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Affiliation(s)
- David Tighe
- Department of Otolaryngology, Birmingham City Hospital, Birmingham, U.K
| | - Andy Wood
- Department of Otolaryngology, Birmingham City Hospital, Birmingham, U.K
| | - Savita Kale
- Department of Otolaryngology, Birmingham City Hospital, Birmingham, U.K
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13
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Macchi V, Porzionato A, Bardini R, Parenti A, De Caro R. Rupture of ascending aorta secondary to esophageal perforation by fish bone. J Forensic Sci 2008; 53:1181-4. [PMID: 18643867 DOI: 10.1111/j.1556-4029.2008.00815.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Perforations of both esophagus and aorta after swallowing foreign bodies have been described, with aorto-esophageal fistulas at the level of the descending aorta or aortic arch. We present the case of a 48-year-old man with esophageal perforation by fish bone, mediastinitis, and evidence of perforation of the ascending aorta during surgical drainage of the mediastinum. At autopsy, a fish bone was found under the aortic arch. Serial histological macrosections of the mediastinic block allowed reconstruction of the type of injury suffered and a thorough analysis of mediastinic structures, with preservation of topographic relationships. Direct demonstration of the perforation of the posterior wall of ascending aorta was provided. Histological examination ascribed aortic perforation to migration of the fish bone and direct injury. This is the first anatomical and pathological study of an autopsy case of perforation of the ascending aorta by fish bone.
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Affiliation(s)
- Veronica Macchi
- Department of Human Anatomy and Physiology, University of Padova, Padova, Italy
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14
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Maseda E, Ablanedo A, Baldó C, Fernández MJ. [Migration and extrusion from the upper digestive tract to the skin of the neck of a foreign body (fish bone)]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2007; 57:474-6. [PMID: 17228649 DOI: 10.1016/s0001-6519(06)78752-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Foreign bodies ingestion is a common problem seen at emergency rooms and mostly involved are fish and chicken bones. The diagnosis can be difficult because of the age of the patient (children and older patients with dental prosthesis). The shape of the foreign body leds to the course of the pathology, with possible mayor complications like migration into the fascial spaces of the neck, retropharyngeal abscess and perforation of the pharynx or esophagus which have the potential to cause morbidity and mortality. We present a 88-year-old lady who swallowed a 3 cm linear sharp fish bone which migrated from the pharynx to the skin of the neck, surfaced through a fistulous orifice and threw out six weeks later. No intervention was needed. A discussion of the management of migrated foreign bodies follows.
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Affiliation(s)
- E Maseda
- Servicio de Otorrinolaringología del Hospital San Agustín, Avilés, SESPA.
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15
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Nisbet M, Thomas M. Liver abscess associated with persistent Streptococcus anginosus bacteremia. Clin Infect Dis 2006. [PMID: 16010707 DOI: 10.1086/431491] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- M Nisbet
- Department of Infectious Diseases, Auckland City Hospital, New Zealand
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16
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Kumar KS, Rajan P, Nampoothiri PM, Jalaludhin J. Penetrating oesophageal foreign body. Indian J Otolaryngol Head Neck Surg 2003; 55:194-5. [DOI: 10.1007/bf02991953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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17
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Abstract
Oropharyngeal penetration and migration of ingested bodies into the neck is extremely rare. This is a case report of a 2-year-old boy who presented with a submental lump 1 day after swallowing a fish bone. The clinical, radiological, and intraoperative findings of the case are discussed.
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Affiliation(s)
- Y H Goh
- Department of Otolaryngology, Singapore General Hospital
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18
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Abstract
Oesophageal penetration and migration of oesophageal foreign bodies into the thyroid gland is extremely rare with only occasional case reports appearing in the medical literature over the years. This is a retrospective review of four patients who were managed for penetrating oesophageal foreign bodies in the thyroid gland over an 11-year period. The clinical, radiological and intra-operative findings of the four cases are discussed.
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Affiliation(s)
- Y H Goh
- Department of Otolaryngology, Singapore General Hospital, Singapore
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19
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Lowinger DS, Makarie L, Cole I, Szasz JJ. Retrieval of an extraluminal swallowed sharp foreign body. THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY 1999; 69:399-402. [PMID: 10353564 DOI: 10.1046/j.1440-1622.1999.01585.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- D S Lowinger
- Department of Otolaryngology, Concord Hospital, New South Wales, Australia.
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20
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van Ooij A, Manni JJ, Beuls EA, Walenkamp GH. Cervical spondylodiscitis after removal of a fishbone. A case report. Spine (Phila Pa 1976) 1999; 24:574-7. [PMID: 10101822 DOI: 10.1097/00007632-199903150-00015] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A case report of cervical spondylodiscitis after removal of a lodged fishbone. OBJECTIVES To present a rare case of cervical spondylodiscitis and to inform the readers that a lodged fishbone can give rise to this complication after its removal. SUMMARY OF BACKGROUND DATA In the literature, only one mention of this complication was found. METHODS The literature, clinical presentation, technical examinations, and treatment are reviewed. RESULTS Prolonged antibiotic treatment and immobilization of the cervical spine resulted in a cure of the spondylodiscitis. CONCLUSIONS After removal of a lodged fishbone, a cervical spondylodiscitis is possible, but this is a very rare complication. In this patient, conservative treatment resulted in a cure of the infection. Successive magnetic resonance imaging investigations showed the extent of the destruction of the vertebral bodies and disc very well, as well as the curation of the spondylodiscitis after 5 months.
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Affiliation(s)
- A van Ooij
- Department of Orthopaedic Surgery, University Hospital Maastricht, The Netherlands.
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21
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Simic MA, Budakov BM. Fatal upper esophageal hemorrhage caused by a previously ingested chicken bone: case report. Am J Forensic Med Pathol 1998; 19:166-8. [PMID: 9662114 DOI: 10.1097/00000433-199806000-00013] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Perforation of the upper esophageal wall by ingested bones can cause sudden death and death under suspicious circumstances. Perforation usually takes place at sites of physiologic and pathologic strictures. Temporary bleeding from the respiratory and digestive tracts is an important signal and may be crucial in the diagnosis of esophageal perforation and small vessel injury by ingested bone. Polymorphism and long symptomatology can cause diagnostic and therapeutic failure, thus presenting a special medicolegal problem. We present a case report of unknown cause of death and death under suspicious circumstances resulting from ingested bone perforation of upper esophagus. A chicken bone had been swallowed about 6 months before death caused by hemorrhage from a decubitus in the cervical esophagus. The patient underwent urgent surgery because of suspected bleeding of a ventricular ulcer.
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Affiliation(s)
- M A Simic
- Department of Forensic Medicine, University of Novi Sad, School of Medicine, FR Yugoslavia
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22
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Murthy PS, Bipin TV, Ranjit R, Murty KD, George V, Mathew KJ. Extraluminal migration of swallowed foreign body into the neck. Am J Otolaryngol 1995; 16:213-5. [PMID: 7661322 DOI: 10.1016/0196-0709(95)90107-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- P S Murthy
- Department of Ears, Nose, and Throat, Unit II, Kasturba Medical College & Hospital, Manipal, S.K., India
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