Imaging of Neck Emergencies

The most common foreign bodies in the pharynx and esophagus include coins, fish bones, batteries, tooth fragment, buttons, and plastic pieces. Although most small foreign bodies will pass through the gastrointestinal tract without producing symptoms, those which cause symptoms most commonly lodge above the cricopharyngeus. Investigation of a patient with pain after eating fish leads to demonstration of fish bone in 21% of the cases, most commonly in the oropharynx. The most common site of impaction of fish bone is the base of the tongue. If no fish bone is demonstrated, the symptoms will usually resolve spontaneously. The complications of fish bone include perforation and sepsis. The most definitive test for evaluation of foreign body in the pharynx is rigid endoscopy.