Dubai: In a bizarre case, a general physician in Dubai endured stomach discomfort for three months, only to finally discover that a 5cm-long fish bone had pierced his intestine, leading to a painful abscess.
In another case, a 20-year-old expat experienced chest discomfort and difficulty swallowing, which was caused by a chicken bone that got lodged in the esophagus (‘food pipe’), causing significant distress and requiring immediate medical intervention.
Such recent medical cases highlighting the hidden dangers of bones accidently swallowed by residents have prompted doctors to underscore the importance of careful eating habits and timely medical attention.
Fish bone in stomach
Dr Akhilesh Sapra, gastrointestinal surgeon with Prime Hospital in Dubai, who treated the patient - the doctor with the stuck fish bone - said the intensity and frequency of the stomach discomfort had increased two weeks ago. Being a healthcare professional himself, the patient had initially resorted to self-treatment and also consulted different specialists later, but the reason for the pain could not be found.
“When symptoms worsened with mild fever and central abdominal pain, he came to me,” said Dr Sapra.
An initial ultrasound was normal, but a CT scan revealed a foreign body piercing his intestines, leading to abscess formation. “The sharp end of the fish bone was dangerously close to a major blood vessel, making any delay potentially life-threatening,” said Dr Sapra.
The doctor-patient underwent a laparoscopic surgery to retrieve the fish bone. He was discharged the next day, resuming work within five days, added Dr Sapra.
• If the bone is visible and within reach, you might be able to remove it carefully with clean tweezers. However, this should be done only if the bone can be seen clearly and be reached without causing more harm.
• A forceful cough might also help dislodge the bone. If not, stay calm and drink water and eat soft foods like rice, bananas, or bread to help push the bone down.
• If the pain persists or if you feel like the bone is stuck in your throat or chest and won’t come out, seek medical help immediately.
• If you experience difficulty breathing, this could be a sign that the bone is obstructing your airway. If there is swelling, redness, or an infection, it’s crucial to get medical attention. Moreover, if you cough up blood or have severe pain, it could indicate a serious injury.
• If the bone doesn’t come out on its own, a doctor might need to perform a procedure to remove it. Endoscopy is a common procedure done to locate and remove the bone. Special forceps and other specialised tools are used during the endoscopic procedure. X-ray or CT Scan also can help locate the bone if it is not visible through an endoscopy.
Chicken bone in esophagus
Dr Mohamed Ahmed Nabil Abdul Aziz Elshobary, specialist and head and clinical lecturer at the Centre of Gastroenterology at Thumbay University Hospital in Ajman, who treated the second patient, said the 20-year-old Yemeni’s case posed a challenge as the chicken bone had got lodged in his esophagus horizontally, obstructing it on both sides.
“It was a challenge to remove it due to the risk of esophageal injury,” he recalled.
Since the case was complicated, he said an X-ray was taken to find the exact location of the chicken bone and determine how it was oriented inside the esophagus. An immediate upper endoscopy was then arranged to remove the bone.
However, attempts to grasp and extract the bone with standard forceps were unsuccessful due to its precarious positioning and the risk of causing lacerations to the esophageal mucosa.
“During the endoscopic procedure, it was decided to break the chicken bone with specialised tools to safely resolve the impaction. This technique reduced the possibility of damaging the mucosa while making it easier to successfully remove the broken bone fragments from the mucus-lined esophagus,” explained Dr Elshobary.
After the chicken bone pieces were removed, the patient was observed for any indications of potential problems, including mucosal tears or esophageal perforation. “To avoid acid-induced irritation and the possible development of an ulcer, a five-day course of oral liquid antacids was prescribed to him,” added Dr Elshobary.
Rushed to emergency
Meanwhile, an Indian expat woman shared her experience of rushing to the emergency room after a fish bone got stuck in her throat.
“I had been on a family trip to Oman and we decided to dine at a restaurant known for its delicious fish grill. The local fish served there were larger than what I was used to in Indian cuisine. Excited to try something new, and I guess it was hurried eating that a sizable fish bone got lodged in my throat. Initially, I attempted to dislodge it by consuming rice and bananas, hoping it would pass, but unfortunately, it remained stuck, causing increasing pain,” she said.
However, the discomfort was so unbearable that she was rushed to the emergency hospital after about an hour. “There, medical professionals used a tongue depressor to carefully manoeuvre the bone downward, a procedure that, although painful, proved successful. Following this, the bone safely passed through my stomach. Since that incident, I have become particularly cautious whenever eating fish, especially the presence of small bones, whether in curry or other dishes,” said the 31-year-old.
‘Don’t ignore pain’
Dr Sapra said: “The message here is to be careful while eating non-vegetarian food, not ignore any abdominal pain, and avoid self-medication. If a patient suspects that he or she has swallowed a fish bone, they should see a doctor urgently and get an X-ray done to locate it. Most bones pass spontaneously, but the patient should undergo sequential X-rays until it is expelled in stool.”
Dr Elshobary said when foreign bodies such as fish or meat bones, or even needles or coins, get stuck in the upper gastrointestinal (GI) tract, prompt diagnosis and treatment are essential for avoiding complications. “Prevention of such food-related incidents can be done through chewing and eating slowly and mindfully.”
