Two Cases of Pneumothorax Induced by Fish Bones Impacted in the Esophagus

Although most digestive tract foreign bodies pass naturally, approximately 10% require endoscopic removal and another 1% require surgical intervention. The upper esophagus is the most common site of foreign body impaction. In the East, fish bones are the most commonly encountered foreign bodies in the esophagus, whereas in the West, meat is the most common. Prompt removal of these impacted foreign bodies is important because they may lead to serious complications, such as esophageal perforation or obstruction. The esophagus is located in the deepest part of the chest and is in close proximity to vital organs, such as the aorta, heart, lungs, and vena cava. Thus, a sharp foreign body that penetrates the esophagus may puncture nearby organs, potentially leading to a variety of intrathoracic organ complications, including an aortoesophageal fistula, pericarditis, and pneumothorax. Although pneumothorax rarely results from fish bones impacted in the esophagus, we report two cases of characteristic pneumothorax caused by fish bone foreign bodies in the esophagus and provide a review of the associated literature.