A migrating swallowed fish bone causing neck abscess and internal jugular vein thrombosis

Abstract

1. ABSTRACT

We present a 42 year old woman who had fish bone impaction while eating .She subsequently used, among others, swallowing of big food bolus to push it down which failed. She presented here after two weeks with a neck abscess. A Computed Tomogram (CT) was done which showed the foreign body (FB) already migrated through the pharyngeal wall into the sternomastoid muscle and an abscess.

 The left Internal Jugular Vein (IJV) was found to be thrombosed.

The characteristic fish bone FB was removed under general anaesthesia (GA) trans cervical.

The Interventional Cardiologist was invited at surgery. Patient was managed for both the abscess and the IJV thrombosis. She has since been discharged to continue anti thrombotic management. Three months after she is still in good health. We reiterate the need to avoid using bolus of food to push down impacted FB but seek early and  appropriate treatment and the need to use CT scan early to identify this rare complication and assist proper management.