Журнал клинических случаев

Is That a Fish Bone?

Abstract

Nir Hirshoren, Jeffrey M Weinberger and Aviv Hirschenbein

Background: Impacted foreign bodies in the esophagus can easily cause mucosal ulceration, inflammation and infections which may result in various fatal complications. Computed tomography was determined to be very useful in the diagnosis of impacted fish bones in the esophagus. Aim: Demonstrate incorrect imaging interpretation as result of enteric opacification following oral administration of medications. Case presentation: A seventy-seven year old woman was referred regarding odynophagia after eating fish. A computed tomography scan of the neck and chest showed a 5 cm long bone in the upper esophagus. However, rigid esophagoscopy failed to identify a bone. Amiodarone is fat-soluble iodine rich antiarrhythmic agent. In our case the high iodine content of amiodarone caused the deceptive computed tomography scan. Conclusion: Medications’ radio-opacification may confuse the physician while searching for foreign bodies.