Finding nemo: imaging findings, pitfalls, and complications of ingested fish bones in the alimentary canal

In Asian cuisine, fish is often prepared whole with the bones. Accidental fish bone (FB) ingestion is not an infrequently encountered condition in the emergency department. An impacted FB in the alimentary canal can lead to potentially life-threatening complications. For impacted FBs that cannot be visualized clinically, radiographs and multidetector computed tomography are helpful in localizing the FB, evaluating for complications, and planning treatment. In this pictorial essay, we illustrate the spectrum of radiological findings of impacted FBs, common imaging pitfalls, and complications. Finally, we highlight the imaging findings that are important to the clinician in planning treatment.