Health Questions and Answers

Question: How do you evaluate the patient with a fish bone in the throat?

Answer:

The dilemma of a fish bone in the throat is whether the symptoms are caused by a retained foreign body or mucosal abrasion. Tenderness on palpation of the neck is an unreliable sign, whereas pooled secretions on laryngoscopy almost always are associated with a retained foreign body. Careful physician examination with visualization and removal of the bone obviates the need for radiologic studies or specialty referral. Plain radiography is rarely helpful; however, barium swallow or CT scan may detect retmned foreign bodies or show a perforation. Removal can be achieved by direct laryngoscopy with Magill forceps or may require subspecialty referral.

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