Obstructive Sialadenitis Caused by Migrated Fish Bone into the Submandibular Gland
Keywords:
Migratory foreign body; Fish bone migration; submandibular sialadenitis; Deep neck infection; CT imaging.Abstract
Background Fish bones are the most frequent foreign bodies to lodge in the upper digestive tract. They often embed in the pharyngeal mucosa due to their sharp tips and causing pain. Patient typically attempt various home remedies to alleviate the pain or dislodge fish bones, only seeking medical attention if symptoms persisted or lead to complications such as difficulty in swallowing, abscess formation or respiratory distress. The presence of fish bones may be overlooked because of the complex anatomy of the pharynx, potentially allowing secondary infection to develop. Case presentation A 35-year-old with no comorbidities presented with a chief complaint of one-day duration of painful left neck swelling which is progressively increased in size. He had visited ENT department earlier for alleged fish bone ingestion; full examination and laryngoendoscopy done were negative. A neck x-ray revealed no abnormalities. Intervention: CECT neck was conducted to rule out deep neck space infection, with suspicion of migrated foreign body. He then underwent left submandibulectomy and a fish bone was extracted from the left submandibular gland. Outcome: The patient was well at follow up and discharged after the left neck swelling and throat pain were completely resolved. Conclusion The presentation of fish bones impaction varies in respect to the site of lodgement and often overlooked. If they are not removed, it will lead to complications as mentioned earlier. CECT of the neck is a useful imaging modality to assess deep-seated neck infection, provide guidance for further management. In this case, we chose an open approach with left submandibulectomy to remove the fish bone which is located deep in the submandibular gland. Post operatively, the patient showed good outcomes and immediate symptoms relief.
Bangladesh Journal of Medical Science Vol. 25 No. 04 October’26 Page: 1354-1357
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Copyright (c) 2026 Muhamad Faisal Arief Mohd Suhaimi, Liyana Ghazali, Irfan Mohamad
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