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Pulido Segura JA, Moreno Torres A, Sanchez Buitrago DA. Una espina en un pajar: espina de pescado alojada en la tiroides. REVISTA COLOMBIANA DE CIRUGÍA 2020. [DOI: 10.30944/20117582.484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introducción. La ingestión accidental de cuerpos extraños como espinas de pescado es muy poco frecuente; en ocasiones, pueden alojarse en el esófago y es posible su migración extraluminal. Este accidente se presenta principalmente en países asiáticos por el gran consulo de pescado. La migración extraluminal de una espina de pescado desde el esófago a la glándula tiroides es aún más infrecuente, con pocos reportes en la literatura.
Objetivo. Presentar nuestra experiencia en el diagnóstico y manejo quirúrgico de un paciente con un cuerpo extraño (espina de pescado) alojado en la glándula tiroides y, asimismo, hacer una revisión de la literatura científica.
Caso clínico. Se presenta una paciente de 53 años, sin antecedentes de importancia y con un cuadro clínico de tres meses de evolución consistente en odinofagia posterior a la ingestión accidental de una espina de pescado. En la ecografía practicada en otra institución se observó un cuerpo extraño alojado en el lóbulo tiroideo izquierdo en relación con la musculatura del esófago. En la tomografía de cabeza y cuello se apreciaba una imagen hiperdensa lineal de 2,6 cm de longitud en la misma localización. En la exploración quirúrgica se encontró tejido fibrótico en la región posterior del lóbulo tiroideo izquierdo y se procedió a practicar una tiroidectomía subtotal izquierda. La evolución posoperatoria fue adecuada.
Conclusiones. La migración extraluminal de cuerpos extraños en el tubo digestivo es factible, sobre todo la de las espinas de pescado por su morfología. La tomografía es la herramienta diagnóstica más confiable para detectar cuerpos extraños alojados en la glándula tiroides. Es necesario conocer las posibles complicaciones y, asimismo, optimizar las posibles intervenciones, pues de eso depende el pronóstico clínico del paciente.
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Chen Q, Chu H, Tong T, Tao Y, Zhou L, Chen J, Liu Y, Peng L. Predictive factors for complications associated with penetrated fish bones outside the upper gastrointestinal tract. Eur Arch Otorhinolaryngol 2018; 276:185-191. [PMID: 30539244 DOI: 10.1007/s00405-018-5242-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 12/06/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE To investigate predictive risk factors for complications associated with migrating fish bones in the surrounding tissue of upper gastrointestinal tract. METHODS A retrospective analysis over 12 years was conducted of 45 cases of buried fish bones in the surrounding tissue of upper gastrointestinal tract with complications. Meanwhile, a control group, including 39 cases of prolonged buried fish bones in the surrounding tissue of upper gastrointestinal tract without complications, was set. Patient clinical data were collected and analyzed to predict the risk factors for complications. RESULTS The results of Chi-square test and univariate analysis both showed a significant difference in length of fish bone (> 2 cm), a history of concurrent medical illness (diabetes mellitus and renal hypofunction), symptoms (medium or heavy pain and dysphagia), and duration of significant symptoms (> 7 days) between the complication group and non-complication group. Multivariate analysis further identified length (> 2 cm), diabetes mellitus, medium or heavy pain, dysphagia, and duration of significant symptoms (> 7 days) as independent risk factors for complications. CONCLUSIONS The consequences of fish bones migrating outside the upper gastrointestinal tract are various in different people. Awareness should be raised when encountering a patient ingesting a long fish bone, having a history of diabetes mellitus, presenting with significant discomforts, or these discomforts lasting for a long time. This study will help practitioners counsel their patients on the risks and `benefits of surgery versus observation of this condition.
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Affiliation(s)
- Qingguo Chen
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, China
| | - Hanqi Chu
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, China
| | - Ting Tong
- Department of Otolaryngology-Head and Neck Surgery, Taikang Tongji (Wuhan) Hospital, Sixin North Road No. 322, Hanyang District, Wuhan, China
| | - Yanling Tao
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, China
| | - Liangqiang Zhou
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, China
| | - Jin Chen
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, China
| | - Yun Liu
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, China
| | - Liyan Peng
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, China.
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Schneider AL, Hicks KE, Matsuoka AJ. Cervical oesophageal perforation secondary to food consumption in a well-appearing patient. BMJ Case Rep 2017; 2017:bcr-2017-222576. [PMID: 29167221 DOI: 10.1136/bcr-2017-222576] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
A 71-year-old woman presented to the emergency department 8 days after ingesting fish with mild neck pain but otherwise demonstrated no signs of infection. X-rays were negative but CT imaging demonstrated a curvilinear radiodense object extending from the posterior cervical oesophagus through the right thyroid lobe terminating in the neck just a few millimetres from the external carotid artery. Rigid oesophagoscopy and direct laryngoscopy were negative and the neck was explored for the foreign body, which ultimately was encountered after a painstaking dissection of the right neck that included skeletonisation of the recurrent laryngeal nerve. Her postoperative recovery was uneventful and after a 3-day course of intravenous antibiotics she was discharged on oral antibiotics, in good condition and tolerating a soft diet.
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Affiliation(s)
- Alexander L Schneider
- Department of Otolaryngology Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Katherine E Hicks
- Department of Otolaryngology Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Akihiro J Matsuoka
- Department of Otolaryngology Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Petrarolha SMP, Dedivitis RA, Perruccio FG, Quirino IDA. Esophagus foreign body in the thyroid gland. Braz J Otorhinolaryngol 2017; 86 Suppl 1:64-66. [PMID: 28941709 PMCID: PMC9422525 DOI: 10.1016/j.bjorl.2017.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 08/16/2017] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Rogério Aparecido Dedivitis
- Universidade de São Paulo (USP), Faculdade de Medicina, Departamento de Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
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Airway Complications from an Esophageal Foreign Body. Case Rep Pulmonol 2017; 2016:3403952. [PMID: 28058124 PMCID: PMC5183758 DOI: 10.1155/2016/3403952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/20/2016] [Accepted: 11/06/2016] [Indexed: 02/05/2023] Open
Abstract
Introduction. Foreign body impaction (FBI) in the esophagus can be a serious condition, which can have a high mortality among children and adults, if appropriate diagnosis and treatment are not instituted urgently. 80–90% of all foreign bodies trapped in the esophagus usually pass spontaneously through the digestive tract, without any medical or surgical intervention. 10–20% of them will need an endoscopic intervention. Case Report. We hereby present a case of a large chicken piece foreign body impaction in the esophagus in a 25-year-old male with mental retardation. Patient developed hypoxemic respiratory failure requiring intubation. The removal required endoscopic intervention. Conclusions. Foreign bodies trapped in the upper gastrointestinal tract are a serious condition that can be fatal if they are not managed correctly. A correct diagnosis and treatment decrease the chances of complications. Endoscopic treatment remains the gold standard for extracting foreign body impaction.
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