Ohbuchi Toyoaki, Tabata Takahisa, Nguyen Khac-Hung, Ohkubo Jun-Ichi, Katoh Akiko, Suzuki Hideaki
Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
J Med Case Rep. 2012 Jun 1;6:140. doi: 10.1186/1752-1947-6-140.
We report an extremely rare case of a migratory fish bone penetrating through the thyroid gland.
A 56-year-old Japanese woman presented with a two-month history of a painless cutaneous fistula in her anterior neck with pus discharge. Endoscopic examinations showed no abnormality, but computed tomography revealed a bone-density needle-shaped foreign body sticking out anteroinferior from the esophagus wall, penetrating through her left thyroid lobe and extending nearly to the anterior cervical skin. A migratory fish bone was suspected, and the foreign body was removed under general anesthetic, combined with a hemithyroidectomy. The injured esophageal mucosa was sutured and closed. Our patient's postoperative course was uneventful, and she was allowed oral food intake seven days after the surgery. No evidence of recurrence was seen over the postoperative follow-up period of 42 weeks.
We should be aware that fish bone foreign bodies may migrate out of the upper digestive tract and lodge in the thyroid gland.
我们报告一例极为罕见的游走性鱼骨穿透甲状腺的病例。
一名56岁的日本女性，颈部前方有无痛性皮肤瘘并伴有脓性分泌物，病史长达两个月。内镜检查未发现异常，但计算机断层扫描显示，一根骨密度的针状异物从食管壁向前下方突出，穿透其左甲状腺叶，几乎延伸至颈部前方皮肤。怀疑是游走性鱼骨，在全身麻醉下取出异物，并进行了甲状腺半叶切除术。对受损的食管黏膜进行了缝合。患者术后恢复顺利，术后七天开始经口进食。在术后42周的随访期内未发现复发迹象。
我们应意识到鱼骨异物可能会从上消化道移出并嵌顿于甲状腺。
