Acute Airway Compromise Due to Suspected Fishbone Ingestion

TL;DR

An elderly woman experienced severe breathing issues after swallowing a fishbone, requiring emergency airway management and successful removal to prevent serious complications.

Contribution

This case highlights the importance of early airway intervention and multidisciplinary management in foreign body ingestion.

Findings

A fishbone lodged in the mid-esophagus caused acute airway compromise requiring intubation.

Prompt imaging and endoscopy led to successful fishbone removal and patient stabilization.

Early intervention prevented respiratory failure and other serious complications.

Abstract

A 68-year-old woman presented to the emergency department (ED) with acute respiratory distress following suspected fishbone ingestion. The patient exhibited significant respiratory distress, and a video laryngoscope evaluation revealed bleeding and edema around the vallecula and arytenoid soft tissues, raising concerns for impending airway compromise. The patient was intubated and admitted to the intensive care unit (ICU) for further management. A soft tissue neck computed tomography scan revealed a fishbone lodged in the mid-esophagus, prompting a gastroenterology consultation for endoscopy. The endoscopy successfully removed the fishbone without complications. After the procedure, the patient remained stable and was monitored in the ICU. This case underscores the importance of early airway intervention in suspected foreign body ingestion and illustrates the role of prompt imaging and multidisciplinary management in ensuring favorable outcomes. Fortunately, the course following intervention was uneventful, and the patient was discharged with no further complications, highlighting the critical role of early intervention and careful management in preventing respiratory failure or other serious sequelae associated with foreign body ingestion.

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