魚骨による急性喉頭蓋炎を呈した1症例

A case of acute epiglottitis due to a fish bone foreign body

はじめに

　咽頭の魚骨異物の患者は発症の日から翌日までに医療機関を受診することが多く，ほとんどの場合，（間接喉頭鏡）喉頭内視鏡で魚骨を確認できる。しかし加齢による咽頭知覚低下や，異物による咽頭や食道壁の粘膜への感染や損傷によって，重篤な合併症を生じることがある。今回われわれは，魚骨異物が原因で急性喉頭蓋炎に至った症例を経験したので報告する。

　Fish bone foreign bodies in the pharyngo-laryngeal region are common and can be often removed as an outpatient. However, in elderly people, imperceptions of their pharyngo-larynx may cause a delay of treatment and lead to severe complications.

　We reported a case of an 81-year-old male with acute epiglottitis due to a fish bone foreign body. The patient developed hoarseness and discomfort of his larynx after eating a grilled yellowtail. He was diagnosed as acute epiglottis by his local doctor and was referred to our hospital. Upon arrival, the epiglottis was swollen and inflamed, but any fish bone could not be detected by the endoscopic examination at outpatient clinic. CT image was effective in depicting the fish bone hidden in the epiglottis. We performed emergency tracheostomy and removal of the fish bone foreign body by direct laryngoscope.