Rare Complication Leads to Complex Surgery
Mumbai: A team of surgeons at Wockhardt Hospitals, Mira Road, successfully removed a fish bone that had pierced through the food pipe of an 11-year-old girl and migrated into her thyroid gland, causing a severe infection and abscess. The team was led by Dr. Chandra Veer Singh, Senior Consultant ENT and Head & Neck Oncosurgeon, along with Dr. Sheetal Radia, Senior ENT Specialist and Head & Neck Oncosurgeon.
Persistent Symptoms Prompt Further Investigation
The young patient arrived at Wockhardt Hospitals with persistent throat pain and difficulty swallowing after eating a fish meal. Initially, doctors suspected that a fish bone was lodged in her throat or food pipe, a relatively common occurrence. However, an upper gastrointestinal endoscopy failed to detect any foreign body.
Consequently, the medical team ordered a CT scan of the neck to investigate further. The scan revealed an unusual and alarming finding: the fish bone had perforated the wall of the food pipe and migrated into the left lobe of the thyroid gland. As a result, it had triggered a deep-seated infection and pus accumulation within the gland.
An Exceptionally Rare Medical Condition
According to Dr. Chandra Veer Singh, such cases are extremely uncommon because foreign bodies that migrate beyond the food pipe and enter the thyroid gland cannot be removed through routine endoscopic procedures.
“By the time the patient came to us, the fish bone had already penetrated the thyroid gland and caused a significant infection. Once the foreign body leaves the food pipe and enters surrounding tissues, open surgery becomes the only effective treatment option,” he said.
Surgical Team Undertakes Delicate Procedure
After stabilizing the patient with intravenous antibiotics, the surgical team proceeded with a complex open neck surgery. As per the press release, Dr. Chandra Veer Singh led the procedure with the participation of Dr. Sheetal Radia.
During the surgery, the team carefully explored the infected thyroid gland, drained the abscess, and located and extracted the fish bone. The procedure demanded exceptional precision because several vital structures lie in close proximity to the thyroid gland. These include the recurrent laryngeal nerve and superior laryngeal nerve, which control voice function, as well as the parathyroid glands, which regulate calcium levels in the body.
Preserving Critical Structures Was Key
Dr. Singh explained that even minor damage to these structures could have led to serious long-term complications.
“Any injury to these nerves could have resulted in permanent voice impairment, while damage to the parathyroid glands could have caused lifelong calcium-related complications. The presence of infection and pus made the dissection even more delicate. Successfully removing the foreign body while preserving all these vital structures was crucial to achieving a good outcome,” he said.
Patient Makes Full Recovery
The surgery was completed successfully, and the 11-year-old girl has recovered well. Her voice remains unaffected, her calcium levels are normal, and she has resumed her daily activities without any complications.
Doctors Highlight Importance of Timely Evaluation
Medical experts note that fish bone ingestion is relatively common, especially in coastal regions and among communities where fish is a dietary staple. In most cases, doctors can easily remove the bone through endoscopy after it becomes lodged in the tonsils or upper food pipe.
However, migration of a fish bone through the wall of the food pipe into the thyroid gland, leading to a thyroid abscess, remains an exceptionally rare occurrence and has only been reported sporadically in medical literature worldwide.
Therefore, doctors at Wockhardt Hospitals, Mira Road, urge people not to ignore persistent throat pain, neck discomfort, or difficulty swallowing after eating fish. Even when initial investigations appear normal, advanced imaging may be necessary to identify hidden complications and ensure timely treatment before more serious consequences develop.