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Background <p>Esophageal foreign bodies represent a common clinical emergency. Sharp foreign bodies, such as fish bones, carry a risk of esophageal perforation and subsequent severe complications. Extraluminal migration into the thoracic cavity is an uncommon but clinically significant occurrence.</p> Case presentation <p>A 58-year-old male presented with a 6-hour history of fish bone ingestion. Initial chest computed tomography (CT) demonstrated an esophageal foreign body with associated perforation; however, rigid esophagoscopy was unsuccessful in localizing the object. Follow-up contrast-enhanced CT revealed migration of the foreign body into the thoracic cavity posterior to the left subclavian artery, accompanied by left-sided pneumothorax and 80% lung compression. Single-port thoracoscopic surgery performed 28&#xa0;h post-admission successfully retrieved a 2.5-cm fish bone and addressed the pulmonary injury. The patient recovered without complications, and follow-up imaging confirmed no delayed sequelae.</p> Conclusions <p>Sequential CT imaging facilitates accurate localization of migrated foreign bodies, while minimally invasive thoracoscopic techniques provide an effective therapeutic option. Multidisciplinary collaboration and imaging-guided clinical decision-making play a critical role in minimizing complications and optimizing outcomes.</p>

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Thoracoscopic retrieval of a rare migrated fish bone in the thorax: a case report with sequential CT evidence and literature review

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月4日

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  • Hengchao Chen,
  • Honghai Ma,
  • Zhe Chen,
  • Zaizai Cao,
  • Nianci Xiao,
  • Shuihong Zhou,
  • Zhitian Wang

摘要

Background

Esophageal foreign bodies represent a common clinical emergency. Sharp foreign bodies, such as fish bones, carry a risk of esophageal perforation and subsequent severe complications. Extraluminal migration into the thoracic cavity is an uncommon but clinically significant occurrence.

Case presentation

A 58-year-old male presented with a 6-hour history of fish bone ingestion. Initial chest computed tomography (CT) demonstrated an esophageal foreign body with associated perforation; however, rigid esophagoscopy was unsuccessful in localizing the object. Follow-up contrast-enhanced CT revealed migration of the foreign body into the thoracic cavity posterior to the left subclavian artery, accompanied by left-sided pneumothorax and 80% lung compression. Single-port thoracoscopic surgery performed 28 h post-admission successfully retrieved a 2.5-cm fish bone and addressed the pulmonary injury. The patient recovered without complications, and follow-up imaging confirmed no delayed sequelae.

Conclusions

Sequential CT imaging facilitates accurate localization of migrated foreign bodies, while minimally invasive thoracoscopic techniques provide an effective therapeutic option. Multidisciplinary collaboration and imaging-guided clinical decision-making play a critical role in minimizing complications and optimizing outcomes.