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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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Lee JW, Randall DR, Kuhn MA. Intraoperative ultrasound-guided retrieval of an extraluminal pharyngoesophageal foreign body. EAR, NOSE & THROAT JOURNAL 2018; 97:202-207. [PMID: 30036433 DOI: 10.1177/014556131809700710] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Pharyngoesophageal foreign bodies (FBs) are common otolaryngologic problems, but challenging cases cause significant patient and surgeon frustration. Extraluminal migration of an FB from the pharynx or esophagus is rare and usually necessitates external neck exploration. Approaching these complicated FBs endoscopically may avoid undue surgical morbidity. We present a case using real-time, intraoperative ultrasound (US) guidance for safe retrieval of a migrated submucosal FB. Intraoperative US is a widely available, powerful technology that can aid in the retrieval of difficult pharyngoesophageal FBs. In appropriate cases, this strategy may circumvent transcervical approaches and their associated risks.
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Affiliation(s)
- Janet W Lee
- UC Davis Department of Otolaryngology, 2521 Stockton Blvd., Suite 7200, Sacramento, CA 95817, USA.
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Gaudin M, Couchet G, Carrieres C, Ribal JP, Rosset E. Finding a needle in the common carotid artery 3 years after ingestion. Ann Vasc Surg 2014; 28:1319.e1-3. [PMID: 24447848 DOI: 10.1016/j.avsg.2013.11.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Accepted: 11/20/2013] [Indexed: 11/28/2022]
Abstract
A woman presented with an ischemic stroke involving the right middle cerebral artery. Investigations revealed a foreign body in the cervical area. It was identified as a metal needle, perforating the posterior pharyngeal wall and migrating into the right common carotid artery (CCA). Three years previously, this patient had complained of odynophagia, brought on by needle ingestion. Three days before her stroke, she had hematemesis, caused by migration of the needle into the CCA. The stroke was caused by migration of the thrombus. This type of event is rarely encountered in Europe. Early recognition could avoid dangerous vascular complications.
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Affiliation(s)
- Marie Gaudin
- CHU Clermont-Ferrand, Service de chirurgie vasculaire, Clermont-Ferrand, France
| | - Geoffroy Couchet
- CHU Clermont-Ferrand, Service de chirurgie vasculaire, Clermont-Ferrand, France
| | - Caroline Carrieres
- CHU Clermont-Ferrand, Service de chirurgie vasculaire, Clermont-Ferrand, France
| | - Jean-Pierre Ribal
- CHU Clermont-Ferrand, Service de chirurgie vasculaire, Clermont-Ferrand, France
| | - Eugenio Rosset
- CHU Clermont-Ferrand, Service de chirurgie vasculaire, Clermont-Ferrand, France.
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5
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Wang S, Liu J, Chen Y, Yang X, Xie D, Li S. Diagnosis and treatment of nine cases with carotid artery rupture due to hypopharyngeal and cervical esophageal foreign body ingestion. Eur Arch Otorhinolaryngol 2012; 270:1125-30. [PMID: 22886383 DOI: 10.1007/s00405-012-2138-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2012] [Accepted: 07/24/2012] [Indexed: 11/26/2022]
Abstract
The aim of our study is to present our experience in the diagnosis and treatment of patients with carotid artery rupture (CAR) due to foreign body ingestion. A total of nine admissions with CAR due to foreign body ingestion were recorded in Second Xiangya Hospital between 1969 and 2011. The carotid artery was sutured with muscle flap coverage in six cases, ligated in three cases. We retrospectively compared different surgical procedures of the patients and their clinical outcomes. Results show that CAR was found in all of these nine cases in imaging examinations or surgery. Among these six patients treated by suture of the carotid artery, five patients had a complete recovery without any complications, one patient underwent common carotid artery (CCA) ligation after suture surgery, but finally died of massive hemorrhage due to uncontrollable infection with carotid artery erosion. Among these three patients treated only by CCA ligation, one patient had no complications, one patient had hemiplegia, and one patient died of severe cerebral edema. Hence, timely diagnosis and open surgery are important for the patients of CAR due to foreign body ingestion. Suture of the carotid artery with muscle flap coverage is a better method compared with ligation of the carotid artery in the treatment of CAR.
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Affiliation(s)
- Shuang Wang
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
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6
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Lahiri S, Ghosh S, Sengupta G, Bakshi U. An unusual presentation of foreign body in the common carotid artery. Indian J Surg 2011; 73:460-2. [PMID: 23204711 PMCID: PMC3236261 DOI: 10.1007/s12262-011-0257-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Accepted: 05/23/2009] [Indexed: 10/18/2022] Open
Abstract
Penetrating trauma to neck resulting in arteriovenous (AV) fistula and aneurysms involving the carotid system are uncommon injuries with life-threatening consequences. We report here a case of a young factory worker who developed a traumatic AV fistula with false aneurysm, with however, no other complications. He was successfully operated when he presented to us two months after the injury and is doing well in follow-up.
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Affiliation(s)
| | | | | | - Udayan Bakshi
- MGM Medical College & LSK Hospital, Kishungunj, Bihar
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7
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Mañas Gómez MJ, Castro Boix S, Echeverri Cifuentes JA, Zanon Navarro V, Armengol Carrasco M. [Carotid-oesophageal fistula due to a foreign body]. Cir Esp 2011; 90:668-70. [PMID: 22032940 DOI: 10.1016/j.ciresp.2011.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2011] [Revised: 08/25/2011] [Accepted: 08/31/2011] [Indexed: 11/15/2022]
Affiliation(s)
- M José Mañas Gómez
- Departamento de Cirugía General y Aparato Digestivo, Hospital Universitari Vall d'Hebron, Barcelona, España.
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8
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Shaariyah MM, Salina H, Dipak B, Majid MNA. Migration of foreign body from postcricoid region to the subcutaneous tissue of the neck. Ann Saudi Med 2010; 30:475-7. [PMID: 20864791 PMCID: PMC2994166 DOI: 10.4103/0256-4947.70565] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Migration of a foreign body from the hypopharynx to the subcutaneous tissue of the neck is a rare event. We report a case of a 48-year-old male who accidentally swallowed a fish bone which was not identified intraoperatively. The patient then presented with migration of the bone to the soft tissue of the neck. We conclude that careful assessment of the patient with a foreign body in the throat is crucial to avoid fatal complications.
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Affiliation(s)
- Mohd Mokhtar Shaariyah
- Department of Otorhinolaryngology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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9
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Abstract
Carotid bleeding is one of the most severe complications in ear, nose and throat (ENT) surgery. It is a rare complication in patients with cancer of the head and neck after radiochemotherapy. We report the case of a 65-year-old man who suffered from cancer of the tonsils (pT2pN1M0) and was treated in 1987 with surgery and local chemotherapy. Since then he reported recurrent bleeding in the left cervical region especially during physical exertion. The patient was re-operated and during surgery the tip of a catheter was found in the external carotid artery, obviously a remnant from a catheter for intra-arterial chemotherapy. The tip was removed, the defect closed and covered with a pectoralis major muscle flap.
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10
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Gan DCC, Huilgol RL, Westcott MJ. Transient ischaemic attack caused by an ingested stingray barb. Med J Aust 2008; 189:668-9. [PMID: 19061468 DOI: 10.5694/j.1326-5377.2008.tb02236.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2008] [Accepted: 10/14/2008] [Indexed: 11/17/2022]
Abstract
A 76-year-old woman reported a fishbone stuck in her throat, but no foreign body was identified. Eight weeks later, she experienced a transient ischaemic attack, and a stingray barb was subsequently removed from the right common carotid artery. To our knowledge, this is the first report of the migration of an ingested stingray barb.
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Affiliation(s)
- Desmond C C Gan
- Department of Vascular Surgery, St Vincent's Hospital, Melbourne, VIC, Australia.
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