Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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A Case of a Pharyngeal Impacted Fish Bone Foreign Body Detected by Finger Palpation

손가락 촉진으로 발견할 수 있었던 인두에 매몰된 생선가시

  • Kim, Heung-Up (Department of Internal Medicine, School of Medicine, Jeju National University) ;
  • Song, Hyung-Joo (Department of Internal Medicine, School of Medicine, Jeju National University) ;
  • Choi, Eun-Kwang (Department of Internal Medicine, School of Medicine, Jeju National University) ;
  • Cho, Yoo-Kyung (Department of Internal Medicine, School of Medicine, Jeju National University) ;
  • Song, Byung-Cheol (Department of Internal Medicine, School of Medicine, Jeju National University)
  • 김흥업 (제주대학교 의학전문대학원 내과학교실) ;
  • 송현주 (제주대학교 의학전문대학원 내과학교실) ;
  • 최은광 (제주대학교 의학전문대학원 내과학교실) ;
  • 조유경 (제주대학교 의학전문대학원 내과학교실) ;
  • 송병철 (제주대학교 의학전문대학원 내과학교실)
  • Published : 2011.04.30
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Abstract

Emergent endoscopy is needed in cases of a fish bone foreign body in the upper gastrointestinal tract. A fish bone foreign body is common in the oral cavity and pharynx and has a high rate of complications because of the characteristic shape. A diagnosis is very difficult when the foreign body penetrates and impacts the surrounding tissue. Computed tomography is useful for the diagnosis; however, direct removal would be impossible if the foreign body was not localized during endoscopy. If the foreign body is anchored to the oral cavity and pharynx, finger palpation is useful to find the impacted fish bone. We report here on a case of an endoscopically missed pharyngeal impacted fish bone foreign body that was finally detected by finger palpation and successfully removed by rescue endoscopy.

상부 위장관의 생선가시 이물은 천공이나 농양 등의 합병증을 유발할 수 있어 응급 내시경을 해야 하는 질환이며 입인두에 많이 발생하고 가늘고 뾰족한 형태적 특징으로 인해 조직을 뚫고 들어가 매몰됨으로써 진단에 지장을 초래하는 경우가 있다. CT가 진단에 도움을 주지만 위치를 안다 하더라도 내시경 당시에 매몰된 부위를 파악하지 못한다면 치료로 이어지기 힘들다. 생선가시가 구강과 인두부분에 매몰되어 있다면 손가락촉진이 진단에 도움이 될 수 있다. 경부 이물감을 호소하는 환자에서 첫 내시경 검사에서는 발견하지 못했으나 CT에서 이물로 보이는 병변을 발견한 후 손가락을 이용한 인두부분의 촉진으로 생선가시로 추정되는 부분을 발견하고 이 부위에 대해 내시경 검사를 다시 하여 점막 밖으로 보이는 생선가시의 끝을 발견하고 성공적으로 제거한 증례를 보고한다.

Keywords

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