Migration of a swallowed blunt foreign body to the neck.Case Rep Otolaryngol. 2014;2014:646785. [PMID: 24592347 DOI: 10.1155/2014/646785]

Migratory Fish Bone in the Hyoglossus: Catch Me if You Can

Foreign body ingestion is one of the most frequently encountered cases in otorhinolaryngology and most of the cases can be managed non-operatively. If left untreated, migration of foreign bodies can occur and presents a significant challenge in patient management. We hereby describe the case of an elderly gentleman who had a preceding history of fish bone ingestion and complained of dysphagia for two days. Clinical examination revealed swelling of the right vallecula with minimal pus discharge. Computed tomography (CT) of the neck confirmed the diagnosis of a migratory foreign body in the neck. He underwent open neck exploration and foreign body removal under intraoperative fluoroscopy guidance. A high index of suspicion of a migratory foreign body is warranted in cases of persistent, unresolved symptoms with the failure of endoscopic evaluation to detect the foreign body. Migratory foreign body of the neck may cause life-threatening complications and requires early surgical intervention.

Unusual cervical foreign body - a neglected thermometer for 5 years: A case report

BACKGROUND

Foreign body in the deep neck is mostly associated with accidental ingestion of the animal spiculate bone which penetrates the full-thickness of the aerodigestive tract into the fascial spaces of the neck. In general, perforation of the esophagus often results in periesophagitis and even fatal abscesses. The presence of a giant foreign body in the neck without obvious symptoms or complications for many years is rare.

CASE SUMMARY

We present the case of a 32-year-old man who intentionally swallowed a thermometer which was unable to be located by endoscopy at his initial visit. He had no remarkable symptoms for 5 years other than paresthesia and limited movement of the left neck until 7 d before this admission. The foreign body was removed successfully by the surgery.

CONCLUSION

The presence of a giant foreign body in the neck without obvious symptoms or complications for many years is rare. Both endoscopic and radiological examinations are essential for the diagnosis of alimentary foreign bodies.

An Unusual Neck Mass: Ingested Chicken Bone

BACKGROUND

Foreign bodies in the upper aerodigestive tract are frequently seen in otolaryngological practice, but migration of an ingested foreign body to the neck is a very rare condition.

CASE REPORT

We present a 66-year-old woman admitted to our outpatient department with a painful neck mass. She had a history of emergency department admission 4 months prior with odynophagia after eating chicken meal. A physical examination revealed a painful and hyperemic mass on the left neck. Antibiotherapy did not relieve the patient's symptoms and signs. A 3-cm linear foreign body was observed in X-ray and computed tomography scans. The symptoms of the patient were relieved after excision of the foreign body.

CONCLUSION

Although it is a rare situation, migration of a foreign body ingested through the aerodigestive tract to the neck should be kept in mind in the differential diagnosis of patients who present with neck masses.

Extra luminal migration of ingested fish bone to the spleen as an unusual cause of splenic rupture: Case report and literature review

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Foreign body ingestion is a relatively common and benign condition; some serious complications, however, can arise.

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Approximately 1% of all ingested FB will cause perforation requiring surgical treatment.

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Sharp FB, such as fish bones, chicken bones and needles, are more prone to migrate outside the gastrointestinal lumen if they are not removed early.

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The patient reported here is the first one in the literature to present a splenic rupture due to extra-luminal migration of an ingested fish bone through the splenic flexure of the colon.

Introduction

The ingestion of foreign bodies (FB) is a common problem worldwide and affects all ages; it is, however, particularly important in the pediatric population and in mentally impaired adults. The typical outcome of FB ingestion is good, since the majority of ingested material is passed spontaneously through the gastrointestinal tract. Serious complications can occur, however, including bowel perforation or obstruction and gastrointestinal bleeding, amongst others. Extraluminal migration of ingested foreign bodies is very rare and reported cases so far have shown, more commonly, migration to neck structures, with very few reported cases of migration to the abdomen. To date, there is no reported case of extraluminal migration of ingested FB to the spleen.

Case presentation

A 59-year-old man presented with acute abdominal pain and dyspnea. A CT scan revealed a FB within the spleen, with a ruptured capsule and perisplenic collection. Surgery was performed and a 3cm-long fishbone was extracted, with hemoperitoneum secondary to spleen rupture. The patient was discharged on the third postoperative day with good recovery and without any complications; pneumococcal polysaccharide vaccination was provided.

Conclusion

FB ingestion is a relatively benign condition; however, some serious complications can arise infrequently. The patient reported herein is the first in the literature to present a splenic rupture due to extra luminal migration of an ingested fish bone.