Neck foreign body - fish bone

Case contributed by Amanda Er

Presentation

Felt fish bone sensation in throat after having fish for lunch. Upper endoscopy procedure negative for foreign body.

Patient Data

Age: 90 years
Gender: Female
X-ray

Neck Soft Tissue Lateral X-Ray

No radio-opaque foreign body identified, with pre-vertebral soft tissues within normal limits.

After plain film and scope images came up negative for a foreign body, a CT Neck was performed.

CT

CT Neck (Non-contrast)

A linear radio-dense foreign body measuring approximately 2.4 cm (morphologically resembling a fish bone) is seen within the cricopharynx and proximal esophagus at C5 to C6-7 level. Much, if not all of it, is extra-luminal. No subcutaneous emphysema or large collection is seen.

Case Discussion

In this case, the patient had a Neck Soft Tissue Lateral X-ray done on initial presentation through the Emergency Department. With no apparent foreign body visualized on the plain film image, an Upper Gastrointestinal Endoscopy was performed. However, that was negative for pathology as well.

A non-contrast CT Neck scan was then carried out, which confirmed the presence of the fish bone.

This case shows the importance of utilizing various modalities to diagnose a patient's issue, with CT being more sensitive than plain film in detecting ingested foreign bodies1.

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Case information

rID: 71612
Published: 14th Oct 2019
Last edited: 14th Oct 2019
Inclusion in quiz mode: Included

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