Lost and Found: The Unexpected Journey of an Ingested Fish bone
Year: 2025
Type: report
Study design: Case Report
Abstract: A case report highlighting the challenges of an ingested foreign body. Introduction:Accidental ingestion of fish bones is a frequent occurrence, particularly in populations where fish is a dietary staple. While most foreign bodies pass uneventfully, migration outside the aerodigestive tract is rare and poses a diagnostic challenge. This case highlights the importance of maintaining clinical suspicion even when initial symptoms appear to resolve. Case Presentation:A 62-year-old male with no significant comorbidities presented with a sensation of a foreign body in the throat and odynophagia following fish consumption. His symptoms improved over several days, but subsequently, he developed swelling over the left side of his neck. Examination revealed a tender, firm mass at left neck levels II–III. Flexible nasopharyngolaryngoscopy showed pooling of pus in the left vallecula, but no visible foreign body. Plain radiography was inconclusive. However, contrast-enhanced computed tomography (CT) of the neck revealed a linear hyperdensity consistent with a migrated fish bone located extraluminally near the left hyoid. The patient underwent surgical exploration via a transcervical approach. A 7 cm incision was made, and dissection revealed a localized abscess and the tip of the fish bone, which was removed successfully. Postoperatively, the patient showed marked clinical improvement and was discharged with oral antibiotics. Discussion:This case underscores the importance of thorough clinical evaluation and the limitations of plain radiography in detecting non-radio-opaque/small foreign bodies. CT imaging played a crucial role in localizing the migrated fish bone. Early surgical intervention prevented potential complications such as deep neck space infection or vascular injury. Conclusion:Persistent symptoms following suspected foreign body ingestion warrant further imaging, even if initial assessments are negative. Clinicians should maintain a high index of suspicion for migration, and contrast-enhanced CT should be considered early in the diagnostic process.
Authors: BIN MOHD KHAIRUL, MUHAMMAD SYAFIQ, kanagaratnam, kuhan, WAN HASSAN, WAN AHMAD AMIRUDDIN, BIN MOHAMAD MAHBOB, HAFIZ
Language: English
Topic: Foreign Body Medical Cases
Subfield: Otorhinolaryngology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7104453053