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Doctor removes 3cm fish bone from woman’s thyroid at Aster Hospital, Mankhool

Wed 17 Jul 2024    
EcoBalance
The Brew News Team | 3 min read

Fish bones typically lodge in the esophagus or throat, making their migration to the thyroid lobe highly unusual but medically significant

Dubai: Aster Hospital Mankhool, ranked No. 5 on Newsweek’s World’s Best Hospitals in the UAE list, recently removed a 3cm fish bone lodged in the thyroid lobe of a 48-year-old Indian woman. Admitted to the Emergency Room on January 15, 2024, the patient presented with mild throat irritation, minimal pain while swallowing, and localized neck pain on the lower right side.

The incident began following the ingestion of fish a few days prior, which initially caused discomfort. Those symptoms subsided after two days, but she then experienced neck pain one week later. Initial examinations using a laryngopharyngoscope revealed no visible foreign body, leading to a subsequent sonogram that identified a suspicious linear object. She was then referred to Aster Hospital Mankhool for specialized management.

The patient underwent a CT scan with contrast, which confirmed the presence of a 3cm fish bone embedded in the right thyroid lobe, penetrating the strap muscle. Under the care of Dr. Deepak Janardhan, E.N.T, Head & Neck Surgery Specialist, and with the support of Dr. Bharath Rao, E.N.T, Endoscopic Nasal & Micro Ear Surgery Specialist, surgical intervention was conducted under general anesthesia, during which the foreign body was successfully extracted, and the wound meticulously closed.

Fish bones stuck in the throat or food pipe are conditions that warrant urgent intervention. They are a common emergency case, often removed by endoscopic treatment. Fish bones can get lodged in the upper digestive tract. It is unusual for them to migrate to the thyroid, where they may cause local infection, abscess formation, or slip to adjacent large blood vessels, causing tears and other serious complications based on injury to other critical structures in the neck.

Dr. Deepak Janardhan, E.N.T, Head & Neck Surgery Specialist at Aster Hospital Mankhool, emphasized the significance of timely intervention in such cases, stating, “Fish bones lodged in the throat can quickly escalate to serious complications if not promptly addressed. In an extraordinary turn of events, this particular fish bone migrated to the thyroid gland—a rare and alarming occurrence. This case underscores the critical need for comprehensive evaluation in managing foreign body ingestions. At Aster Hospital Mankhool, our expert ENT surgeons leverage state-of-the-art diagnostic tools to guarantee precise detection and effective treatment, ensuring our patients receive unparalleled care from highly skilled specialists.”

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Dr. Bharath Rao, E.N.T, Endoscopic Nasal & Micro Ear Surgery Specialist at Aster Hospital Mankhool, added,”Our approach involved careful planning and precise surgery to completely remove the fish bone and ensure the patient’s optimal recovery. Aster Hospital Mankhool has advanced technology and a team of highly skilled specialists, allowing us to handle such cases effectively. It’s crucial for individuals to seek medical attention if they experience persistent symptoms after swallowing a foreign object.”

Although fish bones getting stuck in the throat is not uncommon, when ignored or left unattended, they can lead to severe complications such as life-threatening infections and cervical abscesses. Usually, they are retrieved with flexible or rigid scopes inserted via the mouth. In rare instances, fish bones can migrate to deeper tissues, causing further complications. In this case, the 3cm fish bone migrated from the esophagus to the thyroid gland. The rarity of this case lies in the migration of the fish bone to the thyroid gland, which had the potential to develop into a suppurative abscess if ignored or left untreated. Timely detection and intervention in this case helped the patient achieve faster recovery without complications.

Foreign body (fish bone) induced thyroid infections, such as Acute Suppurative Thyroiditis (AST), are rare and can be potentially life-threatening endocrine emergencies. The incidence of AST accounts for 0.1%–0.7% of all thyroid diseases. Fish bones are not easily detected foreign bodies on X-rays. However, fish bone foreign bodies (FFBs) are the most common food-associated foreign bodies (FBs) in adults, particularly in Asia, whereas meat is more prevalent in Western countries. The esophageal sphincter is the most common site where these bones become lodged, and esophageal fish bone disease tends to occur more frequently in men than in women.

Through this case, Dr. Deepak Janardhan and Dr. Bharath Rao seek to underscore the critical importance of heeding symptoms and signs without delay. They emphasize the need for seeking immediate medical attention, securing an accurate diagnosis, and pursuing prompt treatment to avert severe and potentially life-threatening complications.


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