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It's a cod! Finding Nemo (impacted fishbone) in the emergency department
Aileen McCabe1, Andrew Patton1, Nigel Salter1
1Emergency Department, St Vincent's University Hospital, Dublin, Ireland.
BMJ Case Reports
|June 18, 2017
Summary
A fish bone lodged in the throat caused discomfort for a young woman. It was successfully removed using flexible endoscopy, leading to an uneventful recovery.
Area of Science:
- Otolaryngology
- Medical Imaging
- Gastroenterology
Background:
- Foreign body ingestion is a common occurrence, particularly in emergency departments.
- Fish bone impaction in the pharynx or esophagus can cause significant discomfort and potential complications.
Observation:
- A 23-year-old woman presented with a sensation of a fish bone in her throat after eating cod.
- Initial physical examination revealed no airway compromise, but a lateral neck X-ray showed a linear opacity suggestive of a fish bone.
- Direct laryngoscopy in the emergency department was unsuccessful in visualizing the foreign body.
Findings:
- A fish bone was lodged in the neck, visualized on X-ray.
- Surgical removal via flexible endoscopy was required due to the initial failed visualization.
- The patient experienced a complete and uncomplicated recovery post-procedure.
Implications:
- This case highlights the importance of imaging in diagnosing suspected fish bone impaction, even with a normal initial physical exam.
- Flexible endoscopy is an effective tool for the diagnosis and removal of esophageal foreign bodies.
- Prompt and accurate diagnosis and treatment are crucial for preventing complications associated with retained foreign bodies.
