Shergill Gurshinderpal Singh, Nayak Dipak Ranjan, Dora Asheesh, Shergill Ankur Kaur
Department of ENT, Head and Neck Surgery, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Manipal, Manipal University, Manipal, Karnataka, India.
BMJ Case Rep. 2015 May 20;2015:bcr2015210326. doi: 10.1136/bcr-2015-210326.
Migrating foreign bodies in the aerodigestive tract are uncommon but can pose serious complications. Long-standing migrating foreign bodies can exist manifesting chronic and unusual symptoms such as chronic cough, recurrent episodes of dyspnoea and fever. Adverse body reactions to foreign objects such as adhesions can cause difficulty in their diagnosis, localisation and removal. A thorough clinical and radiographical approach is of immense value in such cases. We report two difficult cases of migrated foreign bodies: a 2-year-old child with a long-standing foreign body that migrated to the upper mediastinum, and an adult patient with a fish bone that migrated to the oropharyngeal muscles. Presentations of these cases were not alike, with chronic unusual recurrent symptoms in one and typical acute symptoms in the other. The diagnosis and precise localisation of both foreign bodies was challenging, and an open approach was employed to remove them.
气道消化道内的移行异物并不常见，但可能引发严重并发症。长期存在的移行异物可能表现为慢性且不寻常的症状，如慢性咳嗽、反复发作的呼吸困难和发热。机体对异物的不良反应（如粘连）会导致其诊断、定位和取出困难。在这类病例中，全面的临床和影像学检查方法具有巨大价值。我们报告两例移行异物的疑难病例：一例是一名2岁儿童，有一个长期存在的异物迁移至上纵隔；另一例是一名成年患者，有一根鱼骨迁移至口咽肌。这两例病例的表现不同，一例有慢性不寻常的反复症状，另一例有典型的急性症状。两个异物的诊断和精确定位都具有挑战性，均采用了开放手术的方法将其取出。
