A fishbone, not to be underestimated
Fish is an indispensable dish on our table. Although fish is delicious, if eating fish is stuck by fishbone, it will not feel good. Most of us must have encountered it. When it is stuck by fishbone, you How are they resolved? Did you eat two mouthfuls of rice, steamed bread, or drink two spoons of vinegar?
Early in the morning, my uncle called and said, "What work are you working on today? I might have been caught by a fishbone when I was eating fish last night, and it hurts when I swallowed something." I heard, "Ah? Didn't you tell me last night?" , "After eating fishbone last night, I ate a lot of steamed buns and leeks, and I also drank vinegar. I thought I would be fine today." "Then hurry up and come to the hospital now!". As a hospital worker, I know very well that small things are small things, but no small things are really big things. Not long after the meeting, my uncle arrived. The otolaryngologist used a laryngoscope to check first, and there was no foreign body. Later, he used a microscope laryngoscope, but still no foreign body was found. Then we went to the gastroscope room. After a series of processes such as payment, queuing, and conversation, the doctor in the gastroscope room found a fishbone under a painless electronic gastroscope. Admitted to our hospital gastroenterology department. The doctor in the gastroscope room told me that the fish had a full length of nearly 3cm, and the average diameter of the esophagus was only 2cm. It had already pierced the esophagus, which was very dangerous! My uncle was hospitalized for a week, and when he was discharged, he said, "I will never eat fish again."
The esophagus is a muscular tube with an average diameter of 2 cm (about 25 cm in length), which originates from the pharynx and continues to the stomach. A normal esophagus has three physiological strictures. The first stenosis: located at the beginning of the esophagus, that is, the junction of the pharynx and the esophagus, surrounded by the cricopharyngeal muscle and the cricoid cartilage, about 15cm from the central incisor. Second stenosis: 7 cm below the esophageal entrance, posterior to the intersection of the left main bronchus, approximately 25 cm from the central incisor. It is formed by the passage of the aortic arch from its left side and the left bronchus from the front of the esophagus. The third stenosis: is the hiatus where the esophagus passes through the diaphragm, and the hiatus is inclined upward from right to left. About 40cm from the central incisor, it is the narrowest part of the esophagus.
If a fishbone is accidentally swallowed when eating fish, these stenoses in the esophagus are the most likely to get the fishbone stuck. Ulcers, esophageal perforation, etc., accompanied by varying degrees of mucosal congestion, edema and bleeding. If the scope of esophageal perforation is small, periesophageal inflammation or limited periesophageal abscess may be formed due to inflammation and adhesion of surrounding tissues. If the perforation is large, the infection can extend down to the mediastinal infection. Thoracic esophageal perforation can not only cause mediastinal infection or even abscess formation, but also involve the adjacent trachea or aorta to perforate;
With the movement of breathing and esophagus, the fishbone entering the esophagus is constantly peristaltic, and may penetrate the esophageal wall to surrounding organs at any time, and may also move into surrounding tissues. The front and back of the esophagus are the trachea and aorta. It is very dangerous to puncture the aorta and puncture the wall of the artery to form a pseudoaneurysm. The pressure of the blood flow in the artery is very high. If the aorta is injured, if you bend over or laugh The action of stabs may lead to the rupture of the pseudoaneurysm, and the fatality rate is very high; the free fishbone, stabbing other organs, will also form pneumothorax, empyema, mediastinitis, liver abscess, etc. The esophagus is still close to the heart, and if the fishbone pierces the heart, it will kill you in just a few tens of seconds.
So what should I do if I get stuck with a fishbone? We need to maintain good eating habits when we eat, and don’t play around while eating. If you accidentally get stuck by a fishbone, you should stop eating immediately. You can bow your head and bend down and try to cough hard. The small fishbone will rush out with the airflow, or stimulate it Throat induces nausea, vomiting, and causes the fishbone to loosen and spit out. If there is no effect, you can gently press the tongue with the handle of the spoon to expose the base of the tongue, and observe the size and position of the fishbone under the light. If you find that the fish is not pierced, and the piercing position is not deep, you can gently remove it with chopsticks or tweezers. If no fishbone is found, it means that the fishbone is deep and difficult to pull out. Or if you see a fishbone, but the fishbone is very thick and firmly pierced, don't pull it out indiscriminately. Ask a professional doctor for help; if you feel pain even after drinking water, or even your neck and chest, don't hesitate, go to the hospital immediately to find a doctor and use professional instruments and equipment to take it out.
Don't drink vinegar, swallow rice balls, eat leeks and other "earth methods". In fact, these methods are dangerous and useless, but there are still many people who don't know it, or even if they know it, they are lucky enough to try it. Drinking vinegar, some people think that softening the fishbone is not advisable, because the vinegar can only stay in the stuck position for a short period of time, it has almost no effect, and it will delay the treatment time. Swallowing boluses or foods high in fiber in an attempt to push the fishbone into the stomach, although partially successful, may result in further penetration into the esophagus or mucosal tearing once the bone has penetrated the esophageal wall In severe cases, it can penetrate the esophageal wall and cause damage to surrounding tissues, organs or blood vessels, resulting in serious complications and even loss of life.
references
Xu Xu, Deng Sheng, Xiong Rongsheng, et al. Analysis of clinical characteristics of 197 cases of esophageal foreign bodies [J]. Clinical Medical Research and Practice, 2017,2(6):126-127
Zhong Haibing, Zhong Yufen. Related risk factors for complications of esophageal fishbone foreign body in adults. World Chinese Journal of Digestion 2015; 23(4): 602-607
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