Fishbone as a Foreign Body in the Pharynx - CT Density for Prediction of Fishbone and the Type of Fish on the Western Coast of Karnataka

Background: Fishbone is a widespread foreign body accidentally swallowed, accounting for about 84% of ingested foreign bodies. Most of the patients do not present with any symptoms. The common sites where foreign bodies get embedded in the upper gastrointestinal tract involve the base of the tongue, the palatine tonsils, the pyriform sinus, and the vallecula. Methods: The Department of Radiodiagnosis and Imaging, Kasturba Medical College Hospital, Mangalore, conducted a cross-sectional study involving CT examination of seven types of commonly consumed fish in the coastal Karnataka region, before and after cooking. After the scan, the ROI was drawn on the skull, hypural, spine, rib, upper jaw, and lower jaw to measure the HU unit for all seven fish. Result: The study reported that the average HU unit of the skull, hypural, spine, rib, upper jaw, and lower jaw of fish before and after boiling. The mean value of skull bone showed 195.4 ± 141.7 and184.9 ± 123.2. The mean values of 284.1 ± 191.8 and 279.7 ± 105.7 for the spine. Similarly, for the hypural 242.1 ± 117.4 and 170.7 ± 100.8. For the ribs, the mean values were shown as 114.1 ± 59.8 and 99.4 ± 49.4. The average value of the upper jaw was 251 ± 198.9 and 116.6 ± 110.7. Conclusion: The study provides an idea of the different ranges of HU value in the fish commonly consumed in the coastal Karnataka region. This information can aid in detecting the fish bone foreign bodies in patients with a suspected history of fishbone impaction.