J Korean Med Sci.  2012 Oct;27(10):1208-1214. 10.3346/jkms.2012.27.10.1208.

Clinical Characteristics of an Esophageal Fish Bone Foreign Body from Chromis notata

• Kim HU
• Song HJ

• KMID: 1778828
• DOI: http://doi.org/10.3346/jkms.2012.27.10.1208

Abstract

Damselfish Chromis notata is a small fish less than 15 cm long and it is widespread in the Indo-Pacific Ocean. Of all the cases of fish bone foreign body (FBFB) disease at our hospital, a damselfish FBFB was very common, and a specific part of the bone complex was involved in the majority of cases. This study was performed to evaluate the clinical characteristics of damselfish FBFB in Jeju Island. We retrospectively reviewed the medical records from March 2004 to March 2011 for foreign body diseases. Among 126 cases of foreign body diseases, there were 77 (61.1%) cases of FBFB. The mean age +/- standard deviation was 57.8 +/- 12.7 yr, and this was higher in females 60.9 +/- 14.6 yr vs 54.1 +/- 8.7 yr. Damselfish was the most common origin of a FBFB 36 out of total 77 cases. The anal fin spine-pterygiophore complex of damselfish was most commonly involved and cause more severe clinical features than other fish bone foreign bodies; deep 2.7 +/- 0.8 cm vs 2.3 +/- 0.8 cm; P < 0.01, more common mural penetration 23/36 vs 10/41; P < 0.01, and longer hospital stay 12.6 +/- 20.0 days 4.7 +/- 4.8 days; P = 0.02. We recommend removing the anal fin spine-pterygiophore complex during cleaning the damselfish before cooking.

Keyword

Foreign Body; Fish Bone; Pterygiophore; Damselfish; Chromis notata

MeSH Terms

Adult
Aged
Animals
Bone and Bones/radiography
Esophagoscopy
*Esophagus
Female
Foreign Bodies/*diagnosis/radiography/surgery
Humans
Length of Stay
Male
Middle Aged
Perciformes
Retrospective Studies
Tomography, X-Ray Computed

Figure

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  Fig. 1 Monthly incidence of fish bones foreign body diseases as observed in this study.

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  Fig. 2 Typical features of a fish bone foreign body due to Chromis notata's anal fin spine-pterygiophore complex (ASPC). (A) The foreign body penetrates both side walls of the esophagus. (B) After the removal, the erosive-penetrated lesions remain at both sides of the esophageal wall. (C) The removed ASPC.

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  Fig. 3 Photography and radiography of the Chromis notata and its ASPC. (A) The raw fish. The arrow head denotes the anal fin. (B) The radiographic finding of the fish. The pterygiophore is deeply inserted to the fish body. Note the ASPC is one of the most radio-opaque portions in the fish skeleton. The pelvic spines (arrow) is also radio-opaque because they lay paired one upon another. (C) The magnified photography of the ASPC. It is a union of a pterygiophore and two anal fin spines (AFS) with a joint. The second AFS is longer than the first AFS. *Pterygiophore; †second AFS; ‡first AFS.

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  Fig. 4 Computed tomographic finding in two patients. (A) A typical case of esophageal damselfish bone foreign body. The ASPC penetrated both sided of the esophageal wall. Note that both sharp ends reached the wall of the descending aorta the inferior vena cava. (B-D) Serial sections of the aortic arch level of another patient. The tip of the damselfish bone penetrated the esophageal wall and the aortic wall (dotted circle).

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