Li Deng, Zeng Wan-Ting, Jiang Jian-Guo, Chen Ji-Chuan
Department of Otolaryngology Head and Neck Surgery, Army Medical Center of PLA, Chongqing 400042, China.
World J Clin Cases. 2024 Mar 6;12(7):1365-1370. doi: 10.12998/wjcc.v12.i7.1365.
A fish spike stuck in the throat is a common ear, nose, and throat (ENT) emergency. However, it is very rare for a fish spike to reach the thyroid tissue through the throat, which is very dangerous and can lead to pharyngeal fistula, cervical abscess, mediastinal abscess, and thyroid abscess. Proper and timely management can help reduce complications, especially in elderly patients.
In the case presented here, the causative factor was dentures, but improper management aggravated the condition. In the case presented here, an elderly woman with a history of accidentally swallowing fish bones for 20 d had a sensation of foreign bodies in her throat. Eventually, computed tomography (CT) of the neck showed that the left side of the thyroid gland had a dense shadow in the form of a stripe.
If a fishbone foreign body is not visible during endoscopic examination but the patient has significant symptoms, the surgeon should be aware that the fishbone may be lodged in the thyroid. To avoid a misdiagnosis, ultrasound, CT, and other tests can be used to clarify the diagnosis. T The first step in treating a fish bone in the thyroid gland is to determine the position of the foreign body and the extent of the infection, and to develop a personalized surgical plan for its removal. At the same time, scientific information should be made available to the general public so that people know that if a fish bone is accidentally lodged, they should not force it to be swallowed or be spit out by inducing vomiting, which are incorrect methods and may aggravate the condition or even cause it to migrate outside the cavity, leading to serious complications, as in this reported case.
鱼刺卡喉是常见的耳鼻喉科急诊。然而，鱼刺经咽喉进入甲状腺组织极为罕见，这非常危险，可导致咽瘘、颈部脓肿、纵隔脓肿和甲状腺脓肿。恰当及时的处理有助于减少并发症，尤其是在老年患者中。
在此病例中，致病因素是假牙，但处理不当使病情加重。在此病例中，一名有意外吞入鱼骨20天病史的老年女性感到咽喉部有异物感。最终，颈部计算机断层扫描（CT）显示甲状腺左侧有一条状致密影。
如果在内镜检查中未发现鱼骨异物，但患者有明显症状，外科医生应意识到鱼骨可能嵌顿在甲状腺中。为避免误诊，可使用超声、CT等检查来明确诊断。治疗甲状腺内鱼骨的第一步是确定异物位置和感染范围，并制定个性化的取出手术方案。同时，应向公众提供科学信息，使人们知道如果鱼骨意外嵌顿，不应强行吞咽或通过催吐吐出，这些都是错误的方法，可能会加重病情，甚至导致其移出腔外，引发严重并发症，如本报道病例所示。
