TY  - JOUR
A1  - Hendricks, Anne
A1  - Meir, Michael
A1  - Hankir, Mohammed
A1  - Lenschow, Christina
A1  - Germer, Christoph-Thomas
A1  - Schneider, Michael
A1  - Wiegering, Armin
A1  - Schlegel, Nicolas
T1  - Suppurative thyroiditis caused by ingested fish bone in the thyroid gland: a case report on its diagnostics and surgical therapy
JF  - BMC Surgery
N2  - Background
Accidental ingestion of fish bone is a common cause of otolaryngological emergency. Migration of the ingested bone into the thyroid gland, however, occurs very rarely. The associated clinical presentation, symptoms and duration of discomfort are also highly variable between patients and can be diagnostically challenging.
Case presentation
Here, we report the case of a 71-year-old female patient presenting with an ingested fish bone that migrated into the right thyroid lobe as a rare cause of suppurative thyroiditis with the clinical features of sepsis. We outline the diagnostic approach, peri- and intraoperative management as well as complications. It is proposed that besides endoscopy, imaging methods such as ultrasound or computed tomography may be necessary to verify the diagnosis and location of an ingested fish bone. Prompt surgical removal of the foreign body and resection of the infectious focus is recommended to minimize the risk of local inflammation, recurrent nerve lesions and septic complications arising from the spread of infection.
Conclusion
Fish bone migration into the thyroid gland is an extremely rare event, the successful detection and surgical management of which can be achieved through a careful interdisciplinary approach.
KW  - fish bone
KW  - foreign body ingestion
KW  - thyroid gland
KW  - thyroiditis
KW  - case report
KW  - surgical management
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-299775
VL  - 22
IS  - 1
ER  - 
TY  - JOUR
A1  - Kelm, Matthias
A1  - Anger, Friedrich
A1  - Eichlinger, Robin
A1  - Brand, Markus
A1  - Kim, Mia
A1  - Reibetanz, Joachim
A1  - Krajinovic, Katica
A1  - Germer, Christoph-Thomas
A1  - Schlegel, Nicolas
A1  - Flemming, Sven
T1  - Early Ileocecal Resection Is an Effective Therapy in Isolated Crohn’s Disease
JF  - Journal of Clinical Medicine
N2  - Despite the increasing incidence and prevalence of Crohn’s Disease (CD), no curative options exist and treatment remains complex. While therapy has mainly focused on medical approaches in the past, growing evidence reveals that in cases of limited inflammation, surgery can suffice as an alternative primary treatment. We retrospectively assessed the disease course and outcomes of 103 patients with terminal Ileitis who underwent primary surgery (n = 29) or received primary medical treatment followed by surgery (n = 74). Primary endpoint was the need for immunosuppressive medication after surgical treatment (ileocecal resection, ICR) during a two-years follow-up. Rates for laparoscopic ICR were enhanced in case of early surgery, but no differences were seen for postoperative complications. In case of immunosuppressive medication, patients with ICR at an early state of disease needed significantly less anti-inflammatory medication during the two-year postoperative follow-up compared to patients who were primarily treated medically. Furthermore, in a subgroup analysis for patients with localized ileocecal disease manifestation, early surgery consistently resulted in a decreased amount of medical therapy postoperatively. In conclusion primary ICR is safe and effective in patients with limited CD, and the need for immunosuppressive medication during the postoperative follow-up is low compared to patients receiving surgery at a later stage of disease.
KW  - Crohn’s Disease
KW  - surgical therapy
KW  - ileocecal resection
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-228822
SN  - 2077-0383
VL  - 10
IS  - 4
ER  -