Abstract
Purpose
To investigate predictive risk factors for complications associated with migrating fish bones in the surrounding tissue of upper gastrointestinal tract.
Methods
A retrospective analysis over 12 years was conducted of 45 cases of buried fish bones in the surrounding tissue of upper gastrointestinal tract with complications. Meanwhile, a control group, including 39 cases of prolonged buried fish bones in the surrounding tissue of upper gastrointestinal tract without complications, was set. Patient clinical data were collected and analyzed to predict the risk factors for complications.
Results
The results of Chi-square test and univariate analysis both showed a significant difference in length of fish bone (> 2 cm), a history of concurrent medical illness (diabetes mellitus and renal hypofunction), symptoms (medium or heavy pain and dysphagia), and duration of significant symptoms (> 7 days) between the complication group and non-complication group. Multivariate analysis further identified length (> 2 cm), diabetes mellitus, medium or heavy pain, dysphagia, and duration of significant symptoms (> 7 days) as independent risk factors for complications.
Conclusions
The consequences of fish bones migrating outside the upper gastrointestinal tract are various in different people. Awareness should be raised when encountering a patient ingesting a long fish bone, having a history of diabetes mellitus, presenting with significant discomforts, or these discomforts lasting for a long time. This study will help practitioners counsel their patients on the risks and `benefits of surgery versus observation of this condition.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Kim HU (2016) Oroesophageal fish bone foreign Body. Clin Endosc 49:318–326
Chen HH, Ruan LX, Zhou SH, Wang SQ (2014) The utility of repeated computed tomography to track a foreign body penetrating the esophagus to the level of the thyroid gland. Oral Radiol 30:196–202
Bilish DP, Rajan GP, Farooque F (2008) Fish bone migration through the cervical spine. Otolaryngol Head Neck Surg 138:407–408
Sinha R, Jana U, Ghatak S, Biswas G, Saha J, Sen I (2015) Use of fluoroscopic guidance to remove a migrating esophageal foreign body. Ear Nose Throat J 94:E30–E33
Pang KP, Tan NG, Chia KH, Tan HM, Tseng GY (2005) Migrating foreign body into the common carotid artery. Otolaryngol Head Neck Surg 132:667–668
Joshi AA, Bradoo RA (2003) A foreign body in the pharynx migrating through the internal jugular vein. Am J Otolaryngol 24:89–91
Birk M, Bauerfeind P, Deprez PH, Häfner M, Hartmann D, Hassan C, Hucl T, Lesur G, Aabakken L, Meining A (2016) Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE). Clin Guideline Endoscopy 48:489–496
Kwon OJ, Park JJ, Kim JP, Woo SH (2013) Vocal cord paralysis caused by stingray. Eur Arch Otorhinolaryngol 270:3191–3194
Chee LW, Sethi DS (1999) Diagnostic and therapeutic approach to migrating foreign bodies. Ann Otol Rhinol Laryngol 108:177–180
Coret A, Heyman Z, Bendet E, Amitai M, Itzchak I, Kronberg J (1993) Thyroid abscess resulting from transesophageal migration of a fish bone: ultrasound appearance. J Clin Ultrasound 21:152–154
Goh YH, Tan NG (1999) Penetrating oesophageal foreign bodies in the thyroid gland. J Laryngol Otol 113:769–771
Watanabe K, Amano M, Nakanome A, Saito D, Hashimoto S (2012) The prolonged presence of a fish bone in the neck. Tohoku J Exp Med 227:49–52
Kumar S, Yu C, Toppi J, Ng M, Hill F, Sist N (2018) The utility of diagnostic imaging in fish bone impaction. Open J Radiol 8:45–52
Devarajan K, Voigt S, Shroff S, Weiner SG, Wein RO (2015) Diagnosing fish bone and chicken bone impactions in the emergency department setting: measuring the system utility of the plain film screen. Ann Otol Rhinol Laryngol 124:614–621
Jahshan F, Sela E, Layous E, Levy E, Assadi N, Shilo E, Ibrahim N, Maayan D, Ronen O (2018) Clinical criteria for CT scan evaluation of upper digestive tract fishbone. Laryngoscope 128:2467–2472
Wu E, Huang L, Zhou Y, Zhu X (2018) Migratory fish bone in the thyroid gland: case report and literature review. Case Rep Med 2018:7345723
Johari HH, Khaw BL, Yusof Z, Mohamad I (2016) Migrating fish bone piercing the common carotid artery, thyroid gland and causing deep neck abscess. World J Clin Cases 4:375–379
Chung SM, Kim HS, Park EH (2008) Migrating pharyngeal foreign bodies: a series of four cases of saw-toothed fish bones. Eur Arch Otorhinolaryngol 265:1125–1129
Funding
This study is funded by National Natural Science Foundation of China (Grant Numbers: 81300827 and 81500791).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Rights and permissions
About this article
Cite this article
Chen, Q., Chu, H., Tong, T. et al. Predictive factors for complications associated with penetrated fish bones outside the upper gastrointestinal tract. Eur Arch Otorhinolaryngol 276, 185–191 (2019). https://doi.org/10.1007/s00405-018-5242-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-018-5242-7