2018 Volume 61 Issue 2 Pages 92-96
Patients with lodgment of ingested fishbone foreign bodies in the pharynx are frequently seen at the department of otorhinolaryngology in hospitals. Fishbones represent the most common example of ingested foreign bodies in Japan. We report a case of an ingested fishbone that migrated from the pharynx to the thyroid gland and had to be removed through a cervical skin incision.
A 49-year-old man who had eaten yellowtail the previous day visited a doctor complaining of painful swallowing. The fishbone could not be identified despite the presence of mucosal edema extending from the laryngeal arytenoid to the hypopharyngeal pyriform fossa on the left side. However, imaging examination revealed a linear calcification about 40 mm in length in the left lobe of the thyroid gland, which was suspected as the fish bone that had presumably migrated out of the pharynx. We then removed the huge fishbone foreign body that was about 42 mm long from the left lobe of the thyroid gland through a cervical skin incision. There was no abscess formation around the fish bone in the thyroid. After the surgery, the laryngeal edema improved promptly with antibiotic and corticosteroid therapy.
When a fishbone foreign body migrates out of the lumen as in this case, it is sometimes not possible to confirm by endoscopic examination, and imaging examination is important when such a condition is suspected.
