BMJ Case Reports 2017; doi:10.1136/bcr-2017-220869
  • Novel diagnostic procedure

It's a cod! Finding Nemo (impacted fishbone) in the emergency department

  1. Nigel Salter
  1. Emergency Department, St Vincent's University Hospital, Dublin, Ireland
  1. Correspondence to Dr Aileen McCabe, aileenmccabe{at}
  • Accepted 30 May 2017
  • Published 15 June 2017


A 23-year-old woman presented to the emergency department (ED) with a sensation of a ‘fish bone’ stuck in her throat after eating cod. On physical examination, while she reported an uncomfortable sensation in her throat, no airway compromise was evident. Clinical examination, including ear, nose and throat (ENT) and oropharyngeal assessment, was unremarkable. A linear opacity consistent with a fishbone was visualised on a soft tissue lateral neck X-ray anterior to the vertebral body of C4–6. One attempt to visualise the fishbone on direct laryngoscopy failed in the ED. The fishbone was later removed the next day via direct visualisation with a flexible endoscope in the operating theatre by the ENT surgical team. The patient’s recovery was uneventful.


  • Contributors AMcC participated in the drafting, revising and conception of the manuscript. AP and NS participated in the revising of the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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