Esophageal perforation - chicken bone

Case contributed by Dr Yair Glick

Presentation

Swallowed a chicken bone, pricking pain in the throat.

Patient Data

Age: 80 years
Gender: Female

Extremely hyperdense linear foreign body (bone) approximately 2.5 cm long lying across the upper esophagus (latero-lateral) at the level of the thyroid. The left esophageal wall is perforated, evident by extraluminal air bubbles. Soft tissue mass isodense to muscle and containing small air bubbles surrounds the chicken bone, extending below it - most probably a piece of chicken.

Case Discussion

Perforation of the alimentary tract by a foreign body is quite rare, even if said foreign body is a bone. Fish bones are commonly swallowed.
People with removable dentures, however, lack much of the tactile sensation when chewing food, which is how a chicken bone can accidentally be swallowed as well. Perhaps the leading culprit is the chicken's fibula, a thin, sharp bone.
Strangely enough, in the case presented here, the thicker edge of the bone perforated the esophagus, not the sharp edge (scroll and see for yourself). The bone was carefully extracted and was indeed the notorious fibula.

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Case information

rID: 68811
Published: 14th Jun 2019
Last edited: 14th Jun 2019
Inclusion in quiz mode: Included
Institution: Laniado Hospital

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