Department of Otolaryngology, Head and Neck Surgery, E-Da Hospital, Kaohsiung, Taiwan.
Ear Nose Throat J. 2024 Dec;103(12):765-768. doi: 10.1177/01455613221086032. Epub 2022 Mar 29.
Accidental swallowing of fish bone is one of the most common emergencies in the otolaryngology department. The impacted fish bones are usually found in the palatine tonsil, base of the tongue, valleculae, pyriform sinus, and esophagus, which can be successfully removed after a thorough examination. However, in some cases, the fish bone may penetrate into the neck soft tissue and migrate to extraluminal organs, causing infection, abscess formation, or rupture of vessels. In such cases, prompt recognition and immediate removal of the impacted fish bone are necessary. Herein, we report a rare case of a 60-year-old woman who had accidently swallowed a fish bone 10 days prior to visiting the outpatient department. The fiberoptic scope and head and neck computed tomography scans were obtained from the outpatient department. The fish bone was found to migrate from the upper esophagus to the left thyroid gland. First, a rigid esophageal endoscopy was performed in the operating room, but no obvious fish bone was noted over the esophagus. Finally, the fish bone was removed via exploratory cervicotomy with left-sided total lobectomy of the thyroid. The patient recovered after the operation, and there were no further complications during the 3 years of follow-up.
误吞鱼刺是耳鼻喉科最常见的急症之一。鱼刺常嵌顿于扁桃体、舌根、会厌谷、梨状窝及食管，经详细检查后可成功取出。但在某些情况下，鱼刺可能穿透颈部软组织并迁移至腔外器官，引起感染、脓肿形成或血管破裂。在这种情况下，需要及时识别并立即取出嵌顿的鱼刺。本文报道了 1 例罕见的 60 岁女性病例，患者于就诊前 10 天误吞鱼刺。从门诊获取了纤维喉镜和头颈部 CT 扫描结果。发现鱼刺从食管上段迁移到左侧甲状腺。首先在手术室进行了硬性食管内镜检查，但食管未见明显鱼刺。最终通过探查性颈侧切开术并行左侧甲状腺全叶切除术取出鱼刺。患者术后恢复良好，随访 3 年均无进一步并发症。
