Ingested bamboo foreign body

Case contributed by Dr Amy Wong

Presentation

3-day history of left-sided sore throat, odynophagia and a foreign body sensation since eating steak wrapped around a bamboo skewer. Flexible nasendoscopy demonstrated supraglottic edema but no foreign body.

Patient Data

Age: 50 years
Gender: Female
CT

Small gas locules in the retropharyngeal region in the midline and slightly to the left at the level of the hypopharynx suggesting localized perforation. No radio-opaque foreign body is seen. There is no large collection evident.

Photo

Extracted foreign body

A 30mm wooden wooden bamboo skewer extracted submucosally from the left posterior pharyngeal wall

Case Discussion

Foreign body ingestion is a common presentation to the emergency department. Many ingested foreign bodies (35% or more) are not radiopaque and include plastic, fish bones, plant material (eg, wood, splinters, thorns), and aluminum. Evaluation with CT with contrast may be indicated in cases of suspected complications. The most common complications are mucosal laceration, bleeding and soft tissue penetration. Serious complications are rare and include esophageal perforation, retropharyngeal abscess, necrosis, extraluminal migration, mediastinitis and pulmonary and cardiovascular penetration. 

This patient had a mucosal breach in the left posterior pharyngeal wall where a 30mm bamboo skewer buried submucosally. 

 

Learning points:

1. Many ingested foreign bodies are not radiopaque. 

2. CT with contrast helps to identify suspected complications of foreign body ingestion including esophageal perforation, retropharyngeal abscess, extraluminal migration, mediastinitis and cardiovascular or pulmonary complications. 

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Case information

rID: 79319
Published: 7th Jul 2020
Last edited: 8th Jul 2020
System: Head & Neck
Inclusion in quiz mode: Included
Institution: Monash Health

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