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A 16-year-old boy comes in with his parents for concern for a fish bone foreign body stuck in the back of his throat. He was eating fish for dinner with his family and feels very strongly that he swallowed a bone which then became stuck in his throat. He has a continued foreign body sensation and dysphagia. On exam, you do not see any foreign body in his oropharynx.
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August 27, 2025 at 8:49 pm
D) Non-contrast CT scan
Fish bones are a common foreign body ingestion. In children, fish bones tend to lodge in the oropharynx, thus visible on physical exam. They are less likely to be in the esophagus due to children’s larger tonsils and smaller caliber esophagus. Plain radiographs, even with multiple views, have poor sensitivity to detect fish bones. POCUS has not been well studied in identifying fish bone foreign bodies. For CT scans, the imaging study of choice if a fish bone foreign body is highly suspected, contrast is not needed since the bone itself is radioopaque.