Cheng Yuan-Chia, Lee Wei-Che, Kuo Liang-Chi, Chen Chao-Wen, Lin Hsing-Lin
Department of Trauma, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Am J Otolaryngol. 2009 May-Jun;30(3):203-5. doi: 10.1016/j.amjoto.2008.03.004. Epub 2008 Jul 22.
Uningested fish bone swallowing is common, but protrusion of the unswallowed fish bone from the neck is very rare. We report a 3-cm fish bone, which was not diagnosed during the patient first visit at emergency room, resulting in a protrusion out of the patient's neck skin 21 days later after ingurgitation of the bone. The migrated fish bone was safety pulled out directly after obtaining computed tomography of the neck to make sure no soft tissue or major artery involved. Migration of ingested fish bone is an uncommon complication, which has the potential risk to cause morbidity and mortality. Therefore, if findings of physical examination, x-rays, or laryngoscope are negative, it is important to recheck the patient if sore throat persists. Obtaining a neck computed tomography or performing gastroendoscopy to rule out the possible mis-swallowing of fish bone should be warranted. To the authors' knowledge, such a case has not been previously reported in medical literature.
未咽下的鱼骨被吞食很常见,但未咽下的鱼骨从颈部突出则非常罕见。我们报告一例3厘米长的鱼骨,患者首次就诊于急诊室时未被诊断出,在鱼骨咽下21天后从患者颈部皮肤突出。在获得颈部计算机断层扫描以确保未累及软组织或大动脉后,直接安全地取出了迁移的鱼骨。吞食鱼骨的迁移是一种罕见的并发症,有导致发病和死亡的潜在风险。因此,如果体格检查、X线或喉镜检查结果为阴性,若咽痛持续,对患者进行复查很重要。应进行颈部计算机断层扫描或胃镜检查以排除鱼骨可能误吞的情况。据作者所知,此类病例此前在医学文献中尚未有报道。