Fish bone foreign bodies in the pharynx and upper esophagus: evaluation with 64-slice MDCT

Background: Fish bone (FB) is one of the common causes of foreign body impaction in the pharynx and esophagus. Purpose: To investigate the efficacy of 64-slice multidetector computed tomography (MDCT) for the evaluation of pharynx and upper esophageal FB foreign bodies. Material and Methods: Sixty-six patients with suspected FB foreign body ingestion were examined by plain radiography (n = 40) and unenhanced MDCT (n = 66). We analyzed the presence, location, size, shape, and lying position of the foreign bodies. Results: On MDCT, 46 foreign bodies were detected. Among them, 45 were confirmed by endoscopy. The sensitivity of MDCT for the detection of foreign bodies was 100%, which was superior to that of the plain radiography (51.7%). The location of the foreign bodies was most common in the upper esophagus (n = 22, 47.8%), followed by pharyngoesophageal junction (n 10, 21.7%), transjunctional (n 7, 15.2%), hypopharynx (n = 5, 10.9%), and oropharynx (n = 2, 4.3%). Their longest length was 5.3-40.1mm (mean, 21.3 mm). Thirty-three FBs (71.7%) were linear and 13 (28.3%) were flat in shape. They showed transverse (n = 23, 50.0%), parallel (n = 13, 28.3%), and oblique positions (n = 10, 21.7%) to the long axis of the pharynx and esophagus, respectively. Conclusion: MDCT is useful for the evaluation of the pharynx and upper esophageal FB foreign bodies.