Sawing Through The Neck - A Case of Serrated Fish Bone Migrating to Prevertebral Space

@#Fish bone is the commonest pharyngeal foreign body, however migrating fish bone is a rare occurrence. We report a case of a 54-year-old male who had history of fish bone ingestion over a week and presented with odynophagia and worsening neck pain. Rigid esophagoscopy revealed tip of a fish bone which was embedded in granulation tissue. The fish bone migrated further with manipulation. Aided with computed tomography scan findings, the serrated fish bone was finally removed via transcervical approach without any complication. In conclusion, high index of suspicion and prompt removal of migrating fish bone with the aid of computed tomography imaging is necessary to avoid fatal complications.

Clinical Application of 3 Dimensional Reconstruction of CT from Fish Bone Foreign Body Model / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This study aimed to gather three-dimensional data to detect fish bones as an esophageal foreign body model and to assess the possibility that this method could be applied for cases of real fish bone foreign body (FBFB). MATERIALS AND METHOD: Fish bones from two species were collected and sizes were measured. Pork meat loaf was placed flat into a plastic box containing plaster cast and bones were laid over the meat layer. Another layer of meat was placed on the bones, then another layer of plaster cast, and the final layer of meat were placed. The meat-bone sandwich was regarded as a fish bone foreign body model of esophagus. The model was imaged using computed tomography (CT) scan and the CT data were reconstructed three-dimensionally making multi-planar reconstruction, maximal intensity projection, and volume rendering images. We tried to find tools to detect the shape and lying position of the FBFB model. The above tools were applied to 3 FBFB cases to verify effectiveness of the tools. RESULTS: Multi-planar reconstruction, maximal intensity projection, and volume rendering images were reconstructed easily. After single or more processing, all of the bones could be detected. The shape and lying positions could be detected using tools made from FBFB models. CONCLUSION: Reconstructed images of CT data readily enabled the detection of fish bone in the esophageal model and real cases.