Choking on a serrated fish bone of more than 2cm in the esophagus

Doctors performed an esophagoscopy on the patient with a soft tube under anesthesia and identified a fish bone foreign object 2cm away from the dental arch.

Information from Central Hospital 108 said that the Hospital’s Department of Ear, Nose and Throat has just received patient NTV (57 years old, Hanoi) admitted to the hospital with a swallowing problem in the neck area, still living normally, not coughing or walking. Other than blood, no fever.

One week before admission, the patient ate fish. 5 days after eating, he had a slight fever, pain in the neck and chest, and difficulty eating.

Doctors performed an esophagoscopy on the patient using a soft tube under anesthesia and identified a fish bone foreign object 2cm away from the dental arch. They removed the fish bone foreign object through endoscopy, but due to the large size and morphology of the bone fragment. It’s complicated and it’s been 5 days so it can’t be picked up, suspecting an esophageal perforation.

Doctors used an ENT endoscope to remove the foreign object, but because the foreign object was hard and had been for 1 week, it was very difficult to remove it. The risk of bleeding and perforation of the esophagus could occur when removing the foreign object. The team creatively used hard, strong tools from the digestive surgery kit to crush the broken bone fragments to remove them, minimizing the risk of bleeding and perforation of the esophagus.

After 45 minutes, the foreign object was successfully removed and checked that there was no bleeding or perforation of the esophagus. Immediately continue to check down to the lower esophagus until the cardia is free of foreign objects, and insert a gastric tube. After surgery, the patient will continue to be monitored for the risk of secondary esophageal perforation and treated at the Gastrointestinal Surgery Department. The patient was stable and was discharged from the hospital on Friday.

According to Dr. Nguyen Tai Dung – Department of Otorhinolaryngology (B9), Central Hospital 108, foreign bodies in the diet are a common ENT emergency in adults and children, more common in adults. If not treated early and promptly, it can easily cause dangerous early complications and death. In children, foreign objects are mostly coins and pieces of toys, followed by food. In adults, it is usually fish bones, chicken bones, and food fragments. If the lesions are not removed promptly, they can abscess around the esophagus, and in severe cases, they can perforate the esophagus. In case the bone is located close to the aortic arch, it will be very dangerous and can be life-threatening when picking up the bone.

According to Dr. Nguyen To Hoai – Department of Gastrointestinal Surgery, Central Hospital 108, in emergency cases of swallowing foreign objects in the digestive tract, fish bones are the most common foreign objects. In many cases, the victim does not know that he has swallowed a foreign object. If moved down the digestive tract, foreign objects such as fish bones, toothpicks or sharp objects can penetrate the intestines into the abdomen or create an infection in the abdomen or chest.

Dr. Hoai also recommends being careful when eating foods with bones, especially for patients who are in the process of getting dentures and cannot chew normally to avoid the risk of swallowing foreign objects.

Besides, during or after a meal, especially when eating foods with hard and sharp bones, if you feel sudden pain in the throat, chest, or abdomen, you should think about the possibility of swallowing a bone. Once known to have swallowed a foreign object, the patient needs to go to a medical facility immediately for timely and effective treatment. Patients should not try to swallow more food or drink water to “flow” because there is a risk of damaging the digestive tract leading to infection and dangerous complications.

Darwin Ferry

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