Migrated prawn tail presenting as neck swelling

Publication date: Available online 13 February 2017
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences
Author(s): Hafizah Husna Johari, Irfan Mohamad, Imran Azmi
Accidental ingestion of food-based foreign body such as fish bones and meat boluses are common among adults. Cases of migrated foreign bodies particularly the sharp-edged ones are also frequently encountered. The presentations of migrated foreign bodies in the neck can initially be asymptomatic and subsequently patients will come with complaint of foreign body or sharp pricking sensation on swallowing, odynophagia, fever or neck swelling. We report a case of a 61-year-old Chinese gentleman who presented with painful left neck swelling with history of eating prawn including its tail 2months prior to presentation. He was symptoms free after eating few boluses of rice since then. With positive findings on imaging studies, the neck lesion was successfully excised under local anesthesia. It contained a migrated intact prawn tail. In conclusion, accidental foreign body ingestion is not uncommon among adults. It is very important to elicit history of foreign body ingestion even in a patient presenting with neck swelling. Besides, oral and neck examination, other investigation modalities such as plain neck radiograph, ultrasonography or computed tomography scan can confirm the diagnosis of migrating foreign bodies and appropriate treatment can be instituted.



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