Choking fish bones, trying to swallow rice causes foreign objects to accumulate deeper
Patient P.V. T (35 years old, residing in Bac Ninh) was admitted to the Central Ear, Nose and Throat Hospital after being choked on a fish bone while eating river snakehead fish hotpot.
According to the patient's account, this type of fish has hard gills. While eating, he suddenly choked on a large bone, causing pain and obvious choking in the throat area.
Initially, the patient tried to spit with the hope that the bone would pop out. However, because the bone had stuck in the mucous membrane, it could not be removed. Thinking that if it could not be spit out, it could be swallowed, the patient continued to handle it by taking a large piece of rice and swallowing it with the hope of pushing the bone down.
This treatment not only does not help the foreign object move but also makes the bone deeper, causing severe pain.
At about 8 pm-8:30 pm on the same day, the patient went to a private clinic for endoscopy but no foreign objects were detected.
The next morning, the patient continued to be examined at another medical facility. Anesthesia and X-rays also did not detect the fish bone. However, the doctor noticed that the injured area was swollen, suspecting that there was still a foreign object, so he advised the patient to go to a higher-level hospital for a CT scan, because the equipment conditions at the facility did not meet the needs to handle this case.
By noon, the patient was transferred to the Central Ear, Nose and Throat Hospital. Preliminary endoscopy here also did not detect any foreign objects. However, CT scan results showed that the fish bone had gone deep into the neck area.
Fish bone pierces the esophagus, enters the neck tissue
According to MSc.BSNT Pham Thuy Linh, Emergency Department, Central Ear, Nose and Throat Hospital, upon admission, the patient showed symptoms of painful swallowing, frequent swallowing, increased phlegm secretion and especially pain in the neck area.
Examination and diagnostic imaging results showed that the foreign object had pierced out of the esophagus, entering the soft tissues of the neck area, including the thyroid area. This condition caused local infection and damage to surrounding structures.
To accurately determine the location as well as the extent of the injury, doctors carefully examine the medical history, the time of foreign object choking, the characteristics of the bone, symptoms and treatments that the patient had performed before.
The patient underwent Ear, Nose and Throat Endoscopy to assess the throat, lower throat and larynx regions. When the endoscopy did not detect any foreign objects, doctors continued to use diagnostic imaging.
In these cases, X-rays may overlook slender or small foreign objects. Therefore, computed tomography (CT-Scanner) plays an important role in determining the location and characteristics of the foreign object, while assessing the condition of the surrounding tissue and possible complications.
The fish bone is thin, difficult to detect and still moves away from its position on the CT scan during surgery, requiring the team to use diagnostic imaging support to locate it. The foreign object was safely removed, and the surrounding tissues were preserved. Currently, the patient is stable, no longer in pain or swallowing problems, eating and living normally.
