Endocrine Abstracts

Patient R., 66 years old. Diagnosis: A foreign body of the thyroid gland. Anamnesis: On 01.12.2023, I ate fish. After swallowing a piece of fish, I felt discomfort in the neck area, a feeling of a foreign body appeared. On 02.12.2023, she turned to an otolaryngologist. During laryngoscopy, it was found that the fish bone stuck into the wall of the esophagus at the level of the larynx. During endoscopic removal, the bone broke off. It was possible to extract a fragment up to 2 cm long. The patient was allowed to go home. The patient had a feeling of a foreign body. The patient performed a CT scan of the neck organs. It was found that a foreign body passed through the wall of the esophagus into the right lobe of the thyroid gland. The length of the formation is 25 mm, the width is 2 mm. The patient was hospitalized in the thoracic department of the regional clinic. In FGDS, damage to the esophageal mucosa has not been established, and no foreign body has been detected. CT scan did not reveal signs of mediastinitis. On 13.12.2023, the patient was discharged with recommendations to contact a specialized center. Treatment at a specialized center on 12/18/2023: the patient’s condition is satisfactory, laboratory parameters are normal. A control ultrasound revealed an inflammatory reaction around a foreign body of the thyroid gland with the threat of purulent strumitis and mediastinitis. The patient is hospitalized. A control ultrasound revealed a pronounced migration of a foreign body (up to 1 mm) towards the vascular bundle of the neck on the right. The distance from the acute end of the foreign body to the carotid artery on the right was 2 mm. On 12/19/2023, an operation was performed: removal of a foreign body of the thyroid gland and soft tissues of the neck. During the revision, it was found that the foreign body migrated to soft tissues, while there was a pronounced scarring process involving the thyroid gland and neck muscles associated with tissue damage by the sharp end of the foreign body and local bleeding. Intraoperative ultrasound was used in the search for a foreign body. The foreign body (fish bone 25 mm) was completely removed, and the patient received antibiotics in the postoperative period. The patient was discharged from the hospital for 5 days in a satisfactory condition.