This is the case of male patient TBT, born in 2006, residing in Tan Hiep district, Kien Giang, admitted to the Ho Chi Minh City ENT Hospital on August 5. About 6 months earlier, the patient had swallowed a fish bone while eating at a party, then went to a local medical facility for examination and no foreign object was found. A week before admission, the patient had pain and swelling under the chin.

At the Ho Chi Minh City ENT Hospital, the doctor noted a hard mass (round inflammatory mass) in the right submental area, about 3cm in diameter, slightly painful when pressed. Through CT scan, a foreign object about 15-16mm long was recorded in the floor of the mouth, with signs of inflammation of the floor of the mouth, inflammation spreading under the chin. The patient TBT was diagnosed with a foreign object in the floor of the mouth, complications of a soft tissue abscess around it.

TBT patient underwent open surgery on the floor of the mouth to drain the abscess and remove foreign objects from the floor of the mouth. During the surgery, the doctor drained about 5ml of pus and removed foreign objects, which were fish bones (2 pieces of bone) about 15mm in size, from the floor of the mouth. The surgical wound is now dry, the patient's stitches have been removed and he is discharged from the hospital.

Doctors at Ho Chi Minh City ENT Hospital examine patients before discharge.

As the person who directly performed the surgery on the patient, Doctor CK II Nguyen Tuong Duc said: “When a foreign object, specifically a fish bone, has “migrated” to the neck area, it poses a great difficulty and challenge for doctors during surgery because this is an area with many large blood vessels. In the case of patient TBT, there was a sign of an abscess that helped the doctor quickly identify the fish bone. However, after removing the fish bone, it was discovered that the size was shorter than the CT scan image, so the doctors continued to search and remove the remaining part of the bone.”

Every year, the Ho Chi Minh City ENT Hospital receives and treats more than 3,000 cases of foreign bodies in the digestive tract. Of these, fish bones are mainly found in adults (accounting for about 84% of foreign body cases in adults).

According to doctors, highly toxic fish bones will cause an abscess immediately when a patient chokes on a bone, but other bones can stay in the body longer. Therefore, when suspecting a fish bone choking, people should not use folk remedies because it can easily make a simple case of choking on a bone complicated.

Dr. Le Tran Quang Minh, MD, PhD, Director of the Ho Chi Minh City ENT Hospital, said: "Foreign body choking still occurs frequently, especially with fish bones that can move from the digestive tract to other areas such as the floor of the mouth, skin, thyroid gland... from several months to a year.

On the way of "migration" of fish bones can cause many complications and injuries. These are very rare cases but need to be detected and intervened promptly because fish bones moving to the neck area containing many large blood vessels, especially the carotid artery, can cause great damage to the patient and make treatment difficult.

News and photos: HUNG KHOA

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