Case presentation
Case 1: migratory fish bone in the
retropharyngeal space.
A 62-year-old male patient had suffered from sudden onset pharyngeal
pain after he had fish. He visited the local hospital. Fiberoptic
laryngoscopy showed that no abnormalities were detected. CT revealed a
foreign body lying transversely at the right piriform fossa.
Subsequently, painless gastroscopy was performed in order to remove
foreign body. Unfortunately, no foreign body was detected. Laryngeal
edema occurred during painless gastroscopy, tracheal intubation was
performed.
The patient was referred to our hospital after 4 days. After admission,
cervical CT was repeated. CT showed that a foreign body was
observed
in the right retropharyngeal space. The foreign body was observed
between cervical vertebra 1 and 2 (Figure 1A, B). Subsequently, he
underwent an exploration of the retropharyngeal space and removal of the
foreign body under general anesthesia. During the operation. Foreign
body cannot be detected in the plane of the second cervical vertebra.
Prolonged the longitudinal
incision was performed to find the fish bone in the surrounding tissues.
Finally, the foreign body was found in the plane of the third cervical
vertebra, which was a fish bone.
After 1 week of follow-up the patient showed no symptoms of pain or
foreign body sensation.
Case 2: migratory fish bone in the hypopharynx.
A 52-year-old man was admitted to our department with throat pain,
foreign body sensation, dysphagia, and mild sialorrhea for 3 days after
eating a meal of fish. Cervical CT confirmed the presence of a linear
radiopaque structure in the left
laryngopharynx (Figure 2A, B).
Flexible fiberoptic laryngoscopy could not identify a foreign body
(Figure 2C). No mucosal lesion was observed. Gastroscope examination
were performed to further ascertain whether there was a foreign body in
the hypopharynx. A fish bone was seen in the left
piriform fossa (Figure 2D). The fish
bone pierced from the left piriform fossa into the posterior pharyngeal
wall. The object was grabbed with foreign body forceps. After the
examination, the patient immediately felt comfortable.