The Lingering Threat: A Migratory Fish Bone Causing Delayed Cervical Foreign Body Granuloma

Area of Science:

• Otorhinolaryngology
• Medical Imaging
• Pathology

Background:

• Fish bone ingestion is a frequent cause for otolaryngology visits.
• Impacted fish bones are often visible, but migratory cases present diagnostic challenges.
• Delayed presentation of extra-pharyngeal migration can lead to severe complications.

Purpose of the Study:

• To highlight the diagnostic challenges of migratory fish bones.
• To present a case of late presentation of fish bone ingestion.
• To emphasize the role of computed tomography (CT) in diagnosing such cases.

Main Methods:

• Case report of an elderly female with delayed presentation of fish bone ingestion.
• Utilized computed tomography (CT) of the neck for diagnosis.
• Surgical removal of the migrated fish bone and associated granuloma.

Main Results:

• A migratory fish bone was identified eight months after ingestion.
• The bone caused an extensive foreign body reaction, forming a large granuloma.
• Surgical removal led to the resolution of neck swelling.

Conclusions:

• Migratory fish bones can present late with significant morbidity.
• Computed tomography (CT) is essential for diagnosing non-visualized or migrated foreign bodies.
• Prompt surgical intervention is key to managing complications from fish bone ingestion.