以頸部腫塊表現之游走性異物

Neck Mass Resulting from Migrated Foreign Body

謝坤衛(Kun-Wei Hsieh) ； 袁本治(Ben-Chih Yua)

《東港安泰醫護雜誌》 12卷4期 (2006/12) Pp. 213-217

https://doi.org/10.7078/TSMHMNJ.200612.0213

摘要

上消化道異物是耳鼻喉科急診常見的病例，種類以魚骨最為常見，常見滯留於扁桃腺、舌根、梨狀窩、下咽或上食道等地方。其中所引起的臨床問題少見為滯留性異物出現在軟組織中，容易造成病患發生嚴重併發症甚至死亡。多數上消化道異物可使用內視鏡及頸部側面X光檢查診斷，當病患有持續不適的症狀，則仍需高度懷疑滯留性異物移行附近組織中，加以電腻斷層掃描，提供最準確的診斷訊息。頸部腫塊原因包羅萬象，但吞入性異物移行至上消化道外造成頸部腫塊卻是罕見，本文所呈現案例中魚刺游走形成頸部皮下腫塊，無上消化道合併症，術後復原情形良好。

關鍵字

上消化道異物 ； 魚刺 ； 游走 ； 嵌入

並列摘要

Ingested foreign bodies are the most common otolaryngological emergency. Most of these objects are fish bones, which typically become lodged in the tonsillar region, tongue base, valleculae, hypopharynx, and upper esophageal wall. Rarely, the foreign body can migrate extraluminally and present in the subcutaneous tissue of the neck or be embedded in the surrounding tissues such as the thyroid gland. Migrating foreign bodies may present in a number of ways and may be associated with life-threatening complications. Investigations by using plain X-ray and endoscopy are commonly performed in cases presenting with suspected foreign body impaction. Foreign body migration should be suspected if there is a suggestive history, or a positive finding in lateral neck radiography, or a negative finding on rigid esophagoscopy and persistent clinical symptoms. Subsequent computed tomography of the neck is the most helpful diagnostic tool to determine the size, type, location and orientation of the foreign bodies and its relationship to the other structures of the neck. This article reports a rare case of an ingested fish bone that migrated from the upper digestive tract and into the soft tissue of the neck just below the skin without any complications. This case also demonstrates a rare presentation of a migrating foreign body, which could have been misdiagnosed as a mass of the neck.

並列關鍵字

ingested foreign body ； fish bone ； migration ； embed