Doctors in Dubai have removed a 2cm fish bone lodged in the airway of a Sharjah resident suffering from a persistent cough, congestion and breathing difficulties.
For nearly two months, the milkfish bone caused problems for unsuspecting Unnikrishnan Sivaraman, a 60-year-old Indian expatriate.
Mr Sivaraman experienced “significant nausea” and bloodstained vomiting but said: “I did not realise that the fish bone had become lodged in my airway.”
He visited a hospital emergency department, but doctors did not identify the cause of his symptoms.
His condition worsened, with a cough, chest congestion and increasing difficulty breathing prompting more medical consultations, before a CT scan revealed the bone.
He was referred to Aster Hospital Mankhool, where further examinations found significant inflammation and granulation tissue, connective tissue that can develop during healing, surrounding the bone.
Dr Jolsana Augustine, a specialist pulmonologist at the hospital, said it was not uncommon for a “foreign body” to end up in a person’s airway, but a fish bone getting stuck there for nearly two months was “unusual”.
“The approximately 2cm fish bone was lodged in the lower airway, extending into the right main bronchus,” she told The National, referring to the vertical airway that leads to the right lung.
“Such cases can be difficult to diagnose and may lead to serious complications if not treated promptly.”
The bone's sharp edges and the surrounding inflammation complicated removal, requiring careful planning involving specialists in ear, nose and throat medicine, pulmonology and anaesthesia.
Surgeons at Aster Hospital Mankhool had to be careful to avoid damaging Mr Sivaraman’s airway and vocal cords.
“We had to take particular care to avoid injury that could affect the patient's voice,” Dr Augustine said.
The procedure involved a bronchoscopy, in which doctors passed a thin instrument into the airways, then moved the bone from the right main bronchus into the upper airway. Surgeons then extracted it using specialised forceps.
Doctors had to minimise the risk of damage to the bronchial wall and surrounding structures, as well as bleeding and sudden airway obstruction. They monitored Mr Sivaraman's oxygen levels throughout the procedure.
The procedure took about 30 to 40 minutes and Mr Sivaraman was discharged from hospital within three hours.
Mr Sivaraman said he was now “doing well” and had enjoyed “significant improvement in my breathing and overall condition” following the operation in September.
“I am grateful to the medical team at Aster Hospital Mankhool for my recovery,” he said.
Fish bones are among the most commonly ingested food-related foreign bodies, particularly in Asia, according to a 2016 study. They are more commonly lodged in the oesophagus, which carries food and liquid to the stomach, than in the airway.
Complications can increase the longer a foreign body remains lodged.
Mr Sivaraman still eats fish but said the experience had made him more careful to check for bones.
Dr Augustine advised people to take care when eating fish, particularly varieties with small or sharp bones.
“Eating slowly, chewing carefully and avoiding talking or laughing while chewing can help reduce the risk,” she said. “Children and older adults may require additional attention while eating fish.”
