魚骨引發咽後膿瘍

Retropharyngeal Abscess from a Fish Bone

在東亞地區最常見的異物是誤吞魚骨頭。咽後膿瘍在臨床上並不少見。但因為誤吞魚骨頭後進一步變成魚骨引發咽後膿瘍的情形卻不常見。我們提出1名59歲女性在2009年10月因晚餐中誤吞魚骨引發咽喉痛而來本院急診求診，起初頸部軟組織X光片在頸椎第2及3節處有細微的高密度顯影。於是再安排患者作電腦斷層，其結果發現魚骨已經完全刺入軟組織並且已經形成咽後膿瘍。因此，安排患者手術，從頸外切開引流膿瘍並且成功地將魚骨移除。所以當病人誤食魚骨且引起咽後膿瘍時，我們可借助電腦斷層來診斷。

Fish bones are the foreign bodies most frequently ingested accidentally by patients in East Asia; however a retropharyngeal abscess after swallowing a fish bone is a rare occurrence. We present the case of a 59-year-old woman who came to our Emergency Department complaining of odynophagia after ingesting a fish bone. On examination, radiography showed tiny areas of unusually high density over the C2-3 level. Computerized Tomography (CT) revealed the penetrating fish bone along with a retropharyngeal abscess. Emergency surgical intervention was then performed to drain the abscess and remove the foreign body. A CT scan can be a great help when we encounter patients with a retropharyngeal abscess due to an accidentally swallowed fish bone.