Presentation
Middle aged female with pain in neck following gobbling a rather delicious asian meal.
Patient Data
Large bony foreign body in the soft tissues of the neck, anterior to the C7 vertebral body.
Small amount of gas surrounding the foreign body.
Arrow indicates position of ingested bone.
A large piece of bone - longer than one vertebral body lies in the pre-vertebral soft tissues at the C7 level.
The gas around it delineates it well.
Large piece of bone removed via fibroendoscopy.
Remarkable how one can swallow a bone this big by accident.
Case Discussion
Ingested bones are a genuine concern - uncorrected a perforation of the pharynx or esophagus may occur.
Fish bones are most commonly swallowed, being small and harder to dissect out of meals. However, on occasion animal bones may also be inadvertently swallowed.
Certain factors make this more likely, like an altered cognitive or mental status as well as following consumption of significant amounts of alcohol.
Warning: ' Don't combine a fried chicken meal with 3 bottles of whiskey' !
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