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Thyroid Pneumatosis Following Fishbone Ingestion: A Rare Case Report.

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Thyroid pneumatosis, a rare condition, was observed after esophageal perforation. This case links destructive thyroiditis to this rare thyroid gas embolism.

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Area of Science:

  • Endocrinology
  • Gastroenterology
  • Radiology

Background:

  • Thyroid pneumatosis is an exceptionally rare condition, with only one prior report linked to ultrasound-guided fine needle aspiration.
  • Esophageal perforation is a potential, albeit infrequent, cause of thyroid pneumatosis.

Purpose of the Study:

  • To report the first case of thyroid pneumatosis secondary to esophageal perforation.
  • To describe the association between thyroid pneumatosis and destructive thyroiditis.

Main Methods:

  • A case study of a 70-year-old male presenting with a retropharyngeal abscess due to fishbone ingestion.
  • Diagnostic imaging including neck computed tomography (CT) to identify gas within the thyroid parenchyma.
  • Monitoring of thyroid function tests (TSH, free T4, free T3) during treatment.

Main Results:

  • The patient developed thyroid pneumatosis and destructive thyroiditis following surgical extraction of a fishbone and treatment of a retropharyngeal abscess.
  • Thyroid function abnormalities were noted initially (low TSH, high free T4, high free T3).
  • Conservative management led to a favorable recovery, with normalized thyroid function within two months.

Conclusions:

  • Thyroid pneumatosis should be considered a rare complication of esophageal perforation.
  • This case is the first to document a link between destructive thyroiditis and thyroid pneumatosis.