Penetrating aero.digestive fish bone injury

Abstract

The aim of the report is to re-emphasize how dangerous fish bone impaction in the esophagus could be and that a combination of pointing sign with radiographic features improves the specificity of the diagnosis. A 45-year-old male civil servant presented with 4 days history of fish bone impaction in the throat while taking meal containing fish with accidental ingestion of fish bone.
This was associated with odynophagia, dysphagia, drooling of saliva, failed attempted dislodgement with swallowed boluses and positive pointing sign. Neck X-ray showed prevertebral widening and radio-opaque  tracheoesophageal penetrating foreign body. He had endoscopy under general anesthesia with retrieval of the fish bone-Laryngo-esophagoscopy showed a laceration in the esophageal mucosal, which penetrated into the laryngeal inlet. This case report re.emphasizes the danger of attempting to dislodge such sharp foreign bodies with boluses of food.