scholarly journals Does plain radiography still have a role in cases of fish bone ingestion in emergency rooms? A retrospective analysis

2021 ◽  
Author(s):  
Tzu-Chi Wu ◽  
Pin-Wen Huang ◽  
Chun-Bin Tung
Keyword(s):  
Computed Tomography ◽  
Symptomatic Relief ◽  
Fish Bone ◽  
Plain Radiography ◽  
Positive Finding ◽  
Emergency Physicians ◽  
Persistent Symptoms ◽  
Fish Bones ◽  
Negative Results ◽  
Primary Management

Abstract Background Fish bones are the most common aerodigestive foreign bodies found in adults. Most cases of fish bone impaction improve after primary management by emergency physicians with a mirror laryngoscopy using a tongue depressor, before otolaryngologists perform a fiberoptic nasendoscopy. A computed tomography scan usually follows to determine the next step. Studies have recently been concerned about overdoses of radiation from computed tomography. However, clear algorithms remain unavailable for fish bone ingestion management to date. Methods A retrospective review was conducted on 180 patients who visited the emergency department with complaints of fish bone impaction between January 2017 and January 2019. Results A total of 81.6% of patients with fish bone impaction got symptomatic relief after primary management by emergency physicians and otolaryngologists. Out of 180 patients, 33 (18.3%) needed an endoscopic procedure due to persistent symptoms. Only one (0.56%) required an operation due to perforation. In the group failing primary management, the plain radiography of eight patients showed a positive finding and an esophagogastroscopy was done to remove the fish bones. Conclusion Lateral neck radiography is still beneficial to patients with fish bone ingestion failure from primary management. Positive lateral soft tissue radiography in cases with persistent symptoms post primary management may directly suggest esophagogastroscopy without confirmation from a computed tomography, unless complications are suspected. For patients aged below 40, following up on their conditions after post management radiography shows negative results may increase their safety.

scholarly journals STOMACH FISH BONE PERFORATION.CLINICAL CASE

2020 ◽  
Vol 46 (3) ◽  
pp. 64
Author(s):  
N.V. Rudik ◽  
A. S. Sementsov ◽  
D. B. Fedchuk
Keyword(s):  
Computed Tomography ◽  
Foreign Body ◽  
Foreign Bodies ◽  
Clinical Observation ◽  
Fish Bone ◽  
Specific Location ◽  
Fish Bones ◽  
Life Threatening ◽  
Wall Perforation ◽  
Tomography Data

Abstract Stomach foreign bodies take second place after foreign bodies of the esophagus and can be both harmless as well as life-threatening. The shape, size, and time of the swallowed foreign body to get deposited in the specific location determine the type of treatment. The article presents a clinical observation – the stomach wall perforation of fish bones, principles of examination of the patient, computed tomography data and surgical treatment. Keywords: stomach, foreign body, perforation, computed tomography, treatment.

scholarly journals DIAGNOSIS AND MANAGEMENT OF A FISH BONE FOREIGN BODY AT ESOPHAGEAL INTROITUS WITH AND WITHOUT RETROPHARYNGEAL ABSCESS

2015 ◽  
Vol 38 (3) ◽  
pp. 238
Author(s):  
Ade Asyari ◽  
Novialdi Novialdi ◽  
Fachzi Fitri ◽  
Yolazenia Yolazenia
Keyword(s):  
Foreign Body ◽  
Soft Tissue ◽  
Lateral Position ◽  
Fish Bone ◽  
Retropharyngeal Abscess ◽  
Intravenous Antibiotic ◽  
Persistent Symptoms ◽  
Fish Bones ◽  
First Case ◽  
Ingested Foreign Body

AbstrakBenda asing yang tertelan merupakan kegawatdaruratan di bidang telinga hidung tenggorok (THT). Tulang ikan merupakan salah satu benda asing di tenggorok yang banyak ditemukan. Abses retrofaring merupakan komplikasi yang sering terjadi akibat tersangkut benda asing ini. Foto polos leher posisi lateral perlu dilakukan untuk kecurigaan adanya lesi di daerah faring. Pasien dengan gejala menetap harus dievaluasi dengan endoskopi, walaupun pada pemeriksaan radiologi tidak tampak. Benda asing harus segera dikeluarkan untuk mencegah komplikasi lebih lanjut. Abses retrofaring diterapi dengan medikamentosa dan drainase pus. Jika terdapat benda asing harus dikeluarkan. Dilaporkan dua kasus benda asing tulang ikan di introitus esofagus. Kasus pertama pada seorang pasien laki-laki umur 42 tahun tanpa abses retrofaring dan kasus kedua pada anak laki-laki berusia 8 tahun dengan abses retrofaring. Tulang ikan terlihat pada ronsen foto leher jaringan lunak posisi lateral. Pada kedua pasien dilakukan esofagoskopi untuk mengambil tulang ikannya dan pada pasien kedua dengan abses retrofaring, absesnya sudah pecah dan pus didrainase dikombinasikan dengan pemberian antibiotik intravena.AbstractForeign body ingestion is an emergency in otorhinolaryngology. One of the most common ingested foreign body is a fish bone. Retropharyngeal abscess is well-documented complication from foreign body ingestion. The soft tissue neck radiograph lateral position is the most significant radiologic examination performed in a patient with a suspected pharyngeal lesion. In patient with persistent symptoms should be evaluated with endoscopy, although radiological examination was negative. We have to extract foreign body immediately to prevent further complication. Retropharyngeal abscess should be treated with medical and drainage of pus. If there is a foreign body must be removed. Two cases of a fish bone foreign body at esophageal introitus was reported. First case in 42 year-old male without retropharyngeal abscess and second case in 8 year-old boy with retropharyngeal abscess. Fish bones were seen from lateral neck soft tissue x-ray. Esophagoscopy were performed to removed fish bones and in the second patient, the abscess had ruptured and the pus was drainage as the treatment combined with intravenous antibiotic.

Use of Plain Radiography and Computed Tomography to Identify Fish Bone Foreign Bodies

2000 ◽  
Vol 123 (4) ◽  
pp. 435-438 ◽  
Author(s):  
Allen J. Lue ◽  
W. Daniel Fang ◽  
Spiros Manolidis
Keyword(s):  
Computed Tomography ◽  
Foreign Bodies ◽  
Fish Bone ◽  
Plain Radiography

Use of plain radiography and computed tomography to identify fish bone foreign bodies

2000 ◽  
Vol 123 (4) ◽  
pp. 0435-0438 ◽  
Author(s):  
Allen J. Lue ◽  
W. Daniel Fang ◽  
Spiros Manolidis
Keyword(s):  
Computed Tomography ◽  
Foreign Bodies ◽  
Fish Bone ◽  
Plain Radiography

The usefulness of computed tomography in the diagnosis of impacted fish bones in the oesophagus

1998 ◽  
Vol 112 (4) ◽  
pp. 360-364 ◽  
Author(s):  
Ken-ichi Watanabe ◽  
Toshihiko Kikuchi ◽  
Yukio Katori ◽  
Hiroko Fujiwara ◽  
Reiji Sugita ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Simulation Model ◽  
Foreign Bodies ◽  
Fish Bone ◽  
X Ray ◽  
Fish Bones ◽  
Inflammatory Changes

AbstractThe usefulness of computed tomography (CT) in the diagnosis of fish bone impaction in the oesophagus was evaluated. Thirty-two patients were examined by plain X-ray followed by direct oesophagoscopy for suspected fish bone impaction. Among 25 cases in which fish bones were actually removed, foreign bodies were not clearly demonstrated by plain X-ray in 14 cases (56 per cent). Eleven cases underwent CT prior to the oesophagoscopic examination. Fish bones were clearly demonstrated by CT in all patients. CT also clearly visualized secondarily-induced inflammatory changes in the neighbouring structures. In order to confirm this result, we made a simulation model of oesophageal fish bone impaction, using fish bones of three different species surrounded by a water bag. In comparison with plain X-ray, CT depicted a superior image of fine fish bones and provides extremely useful information for the management of impacted fish bones in the oesophagus.

Computed Tomography Findings of Emergency Cases Resulting From Fish Bone Ingestion

2020 ◽  
pp. 084653711989919 ◽  
Author(s):  
Shintaro Ichikawa ◽  
Hiroshi Onishi ◽  
Utaroh Motosugi
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Foreign Bodies ◽  
Fish Bone ◽  
The Body ◽  
Fish Bones ◽  
Ct Findings

Fish bones are some of the most commonly ingested foreign bodies. In most cases, fish bone ingestion is asymptomatic, and the bones are expelled from the body spontaneously. Otherwise, patients with fish bone ingestion can present to the emergency department with nonspecific symptoms. Fish bones can become impacted in various part of the body. Even in cases that are initially asymptomatic after ingestion, serious complications may develop at a later stage. Computed tomography (CT) plays an important role in the diagnosis of fish bone ingestion because it is the most sensitive modality for detecting these foreign bodies. It is important to be familiar with CT findings to detect ingested fish bones and the related complications and to direct further management of the condition.

Fish bone as a foreign body

2003 ◽  
Vol 117 (7) ◽  
pp. 568-569 ◽  
Author(s):  
Manoj Kumar ◽  
George Joseph ◽  
Seena Kumar ◽  
Malcolm Clayton
Keyword(s):  
Foreign Body ◽  
Digestive Tract ◽  
Foreign Bodies ◽  
Diagnostic Value ◽  
Fish Bone ◽  
Plain Radiography ◽  
X Rays ◽  
X Ray ◽  
Fish Bones ◽  
The Uk

Fish bones are one of the most common foreign bodies in the upper aero-digestive tract. The use of plain X-ray in identifying fish bones has questionable value. We believe that the knowledge of the type of the fish ingested improves the diagnostic value of the neck X-rays. This study was designed to evaluate the relative radio-densities of the bones of commonly eaten fish in the UK. Twenty-three species of fish were studied and their bones were grouped into three depending upon their ratio-densities. This information is expected to be useful in identifying fish bones while reading plain radiography.

scholarly journals Accuracy of Contrast Extravasation on Computed Tomography for Diagnosing Severe Pelvic Hemorrhage in Pelvic Trauma Patients: A Meta-Analysis

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 63
Author(s):  
Sung Nam Moon ◽  
Jung-Soo Pyo ◽  
Wu Seong Kang
Keyword(s):  
Computed Tomography ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Pelvic Trauma ◽  
Test Accuracy ◽  
Trauma Patients ◽  
Positive Finding ◽  
Summary Receiver Operating Characteristic ◽  
Contrast Extravasation ◽  
Pelvic Hemorrhage

Background and objective: The early detection of underlying hemorrhage of pelvic trauma has been a critical issue. The aim of this study was to systematically determine the diagnostic accuracy of computed tomography (CT) for detecting severe pelvic hemorrhage. Materials and Methods: Relevant articles were obtained by searching PubMed, EMBASE, and Cochrane databases through 28 November 2020. Diagnostic test accuracy results were reviewed to obtain the sensitivity, specificity, diagnostic odds ratio, and summary receiver operating characteristic curve of CT for the diagnosis in pelvic trauma patients. The positive finding on CT was defined as the contrast extravasation. As the reference standard, severe pelvic hemorrhage was defined as an identification of bleeding at angiography or by direct inspection using laparotomy that required hemostasis by angioembolization or surgery. A subgroup analysis was performed according to the CT modality that is divided by the number of detector rows. Result: Thirteen eligible studies (29 subsets) were included in the present meta-analysis. Pooled sensitivity of CT was 0.786 [95% confidence interval (CI), 0.574–0.909], and pooled specificity was 0.944 (95% CI, 0.900–0.970). Pooled sensitivity of the 1–4 detector row group and 16–64 detector row group was 0.487 (95% CI, 0.215–0.767) and 0.915 (95% CI, 0.848–0.953), respectively. Pooled specificity of the 1–4 and 16–64 detector row groups was 0.956 (95% CI, 0.876–0.985) and 0.906 (95% CI, 0.828–0.951), respectively. Conclusion: Multi-detector CT with 16 or more detector rows has acceptable high sensitivity and specificity. Extravasation on CT indicates severe hemorrhage in patients with pelvic trauma.

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