Anterior cervical abscess caused by migration of an ingested fish bone in a child: A case report

Migration of an ingested fish bone beyond the esophageal wall is an exceptionally rare complication in children and may result in deep neck infections requiring urgent surgical management. Contrast-enhanced computed tomography (CT) plays a pivotal role in establishing the diagnosis and guiding treatment. A previously healthy 9-year-old boy presented with a progressively enlarging anterior cervical swelling associated with dysphagia and odynophagia 15 days after accidental fish bone ingestion. Clinical examination revealed a tender inflammatory cervical mass, while laboratory tests demonstrated neutrophilic leukocytosis and elevated C-reactive protein levels. Contrast-enhanced CT identified a 19-mm linear hyperdense foreign body that had migrated into the right cervical soft tissues and was surrounded by a rim-enhancing anterior cervical abscess measuring 42 × 33 × 41 mm, without vascular involvement. Surgical cervicotomy enabled complete abscess drainage and successful removal of the migrated fish bone. The postoperative course was uneventful, with complete clinical recovery. Although uncommon, transmural migration of an ingested fish bone should be considered in patients with persistent cervical symptoms following foreign body ingestion. Contrast-enhanced CT is the imaging modality of choice for accurately localizing the migrated foreign body, assessing associated complications, excluding vascular involvement, and facilitating surgical planning. Early diagnosis and prompt surgical intervention are essential to achieve favorable outcomes and prevent potentially life-threatening complications.