Ingested bones

Dr Dan J Bell and Dr Henry Knipe et al.

Ingested bones that become lodged in the throat or gastrointestinal tract are a common presentation to the emergency department. Recognition is important because these cases can be potentially fatal. 

Patients may present with a 'foreign body' feeling in the throat after eating fish but the rates of actual fish bone presence is ~20%. They are most commonly lodged in the oropharynx 1. Less commonly other bones are ingested, such as chicken or pork.

Plain radiograph
  • lateral neck radiograph
    • sensitivity of direct visualisation of fish bone is low at ~ 35% (range 25-39%) 1, 2, 3
      • fish bones have variable opacity, depending on species of fish 2
      • can be obscured by soft tissue swelling or fluid 2
    • indirect signs 1
      • prevertebral soft tissue swelling (develops 3-12 hours after ingestion)
      • soft tissue or oesophageal gas
  • abdominal radiograph
  • more sensitive (~95%) than plain films in detection of ingested fish bones 2, 3
  • can be mistaken for normal structures or obscured by oral contrast 2

Most ingested foreign bodies usually pass without complications within a week of ingestion with perforations being rare, occurring in <1% of patients. However, fish bones are the most common cause of perforation 2 and the most common site of perforation is the terminal ileum followed by the duodenum and rectosigmoid 6, 7.

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Article information

rID: 27907
Section: Gamuts
Synonyms or Alternate Spellings:
  • Fish bone in the throat
  • Fish bones in the throat
  • Fish bone in gastro-intestinal tract
  • Ingested fish bones
  • Ingested fish bone
  • Chicken bone in the throat
  • Chicken bones in the throat

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Cases and figures

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    Case 1
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    Case 2
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    Case 3: soft tissue gas from fish bone
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    Case 4
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    Case 5
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    Case 6: a large animal bone
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    Case 7
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    Case 8: fish bone with oesophageal perforation
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    Case 9: resulting in liver abscess
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    Airway is not com...
    Case 10: with oesophageal rupture
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