Diagnostic and therapeutic approach to migrating foreign bodies

Area of Science:

• Otolaryngology
• Gastroenterology
• Radiology

Background:

• Ingested foreign bodies are a common emergency in Southeast Asia.
• Migration of foreign bodies is a rare but serious complication.
• This complication can lead to significant morbidity and mortality.

Purpose of the Study:

• To evaluate the presentation, investigation, and diagnosis of migrated foreign bodies.
• To identify factors contributing to successful outcomes in patients with migrated foreign bodies.
• To present the largest case series on migrated foreign bodies to date.

Main Methods:

• Retrospective study of 24 patients from 1990-1996 at Singapore General Hospital.
• Analysis of patient presentations, diagnostic investigations, and treatment outcomes.
• Review of imaging findings, including neck radiography and computed tomography.

Main Results:

• All migrated foreign bodies were linear, sharp fish bones.
• Migration was suggested by positive neck radiography and negative rigid esophagoscopy.
• Computed tomography was the preferred imaging modality for confirming migration.
• All patients underwent neck exploration for foreign body removal.

Conclusions:

• Migrated foreign bodies, particularly fish bones, require prompt diagnosis and management.
• Computed tomography is crucial for confirming migration.
• Surgical exploration is necessary for successful removal.
• Early diagnosis and intervention are vital to prevent complications.