In a rare and medically remarkable case, a team led by Dr. Chandra Veer Singh, Senior Consultant ENT and Head & Neck Oncosurgeon at Wockhardt Hospitals, Mira Road, along with Dr. Sheetal Radia, Senior ENT Specialist & Head and Neck Oncosurgeon, successfully removed a fish bone that had pierced through the food pipe of an 11-year-old girl and migrated into her thyroid gland, causing a severe infection and abscess within the gland.
The 11-year-old patient arrived at Wockhardt Hospitals, Mira Road, complaining of persistent throat pain and difficulty swallowing after consuming a fish meal. While such symptoms commonly indicate a fish bone lodged in the throat or food pipe, an initial upper gastrointestinal endoscopy failed to detect any foreign body.
Suspecting an unusual complication, doctors proceeded with a CT scan of the neck, which revealed a startling finding. The fish bone had perforated the wall of the food pipe and migrated into the left lobe of the thyroid gland, where it had triggered a deep-seated infection and accumulation of pus.
According to Dr. Chandra Veer Singh, the case was exceptionally rare because foreign bodies that migrate outside the food pipe and enter the thyroid gland cannot be retrieved through routine endoscopic procedures.
“By the time the patient came to us, the fish bone had already penetrated the thyroid gland and caused a significant infection. Once the foreign body leaves the food pipe and enters surrounding tissues, open surgery becomes the only effective treatment option,” he explained.
After stabilizing the patient with intravenous antibiotics, the surgical team at Wockhardt Hospitals, Mira Road, led by Dr. Chandra Veer Singh with the participation of Dr. Sheetal Radia, Senior ENT Specialist & Head and Neck Oncosurgeon, performed a complex open neck surgery. The procedure involved carefully exploring the infected thyroid gland, draining the abscess, and locating and extracting the fish bone. The surgery was particularly challenging because several critical structures lie within millimetres of the thyroid gland, including the recurrent laryngeal nerve and superior laryngeal nerve, which control voice function, as well as the parathyroid glands, which regulate calcium levels in the body.
“Any injury to these nerves could have resulted in permanent voice impairment, while damage to the parathyroid glands could have caused lifelong calcium-related complications. The presence of infection and pus made the dissection even more delicate. Successfully removing the foreign body while preserving all these vital structures was crucial to achieving a good outcome,” said Dr. Singh.
The surgery was completed successfully, and the 11-year-old girl has made an excellent recovery. Her voice remains unaffected, calcium levels are normal, and she has resumed her routine activities without complications.
Medical experts note that fish bone ingestion is relatively common, particularly in coastal regions and among populations where fish is a dietary staple. In most instances, the bone becomes lodged in the tonsils or upper food pipe and can be removed easily through endoscopy. However, migration through the wall of the food pipe into the thyroid gland, resulting in a thyroid abscess, is an exceptionally uncommon occurrence and has been reported only rarely in medical literature worldwide.
Doctors at Wockhardt Hospitals, Mira Road, say the case serves as an important reminder that persistent throat pain, neck discomfort, or difficulty swallowing after eating fish should never be ignored. Even when initial investigations appear normal, further imaging may be necessary to detect hidden complications and ensure timely treatment before serious consequences develop.
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