Journal of Emergencies, Trauma, and Shock
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LETTER TO EDITOR  
Year : 2014  |  Volume : 7  |  Issue : 2  |  Page : 134-135
Fishing with Magill forceps


Department of Emergency Medicine, St. Johns Medical College Hospital, Bangalore, Karnataka, India

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Date of Web Publication16-Apr-2014
 

How to cite this article:
Narayan G, Rao R. Fishing with Magill forceps. J Emerg Trauma Shock 2014;7:134-5

How to cite this URL:
Narayan G, Rao R. Fishing with Magill forceps. J Emerg Trauma Shock [serial online] 2014 [cited 2020 Jul 11];7:134-5. Available from: http://www.onlinejets.org/text.asp?2014/7/2/134/130894


Dear Editor,

A 23-year-old fisherman presented to the emergency room with difficulty in speaking and a foreign body in his throat. The patient was a freshwater fisherman and the technique he employed was to keep a live fish in his mouth and submerge himself under water. The flapping fish would serve to attract other fishes. The fisherman would then proceed to grasp nearby fishes with his hands and throw them out of water. On this occasion, the fish swam further into his mouth and slipped into his throat. Upon examination the patient's vital signs and oxygen saturation were normal. Oral examination revealed no abnormality and the foreign body could not be visualized.

Lateral radiograph of the neck [Figure 1] showed a fish tail bone lodged in the hypopharynx distending the pharynx and compressing the larynx anteriorly. Patient was sedated with ketamine 100 mg intravenously. Upon direct laryngoscopy, a fish tail was seen and the vocal chords were clearly visualized with no obstruction. The fish tail was grasped with Magill forceps and extracted. The patient recovered with no side-effects and was discharged with advice to consider an occupational method change.
Figure 1: Lateral radiograph of the neck demonstrates a fish tail bone lodged in the hypopharynx distending the pharynx and compressing the larynx anteriorly

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Upper airway foreign bodies in adults are usually food particles, pills and dental prosthetics. [1],[2] When there is pharyngeal foreign body symptoms vary with the degree of obstruction. Dysphonia, dysphagia and some respiratory distress are present. [1],[3] Patients can be subjected to radiography as long as oxygenation is being maintained and there is no airway emergency. There have been a number of reports demonstrating Magill forceps use in extraction of foreign bodies mainly in children. [4],[5],[6] Direct laryngoscopy and extraction with Magill forceps can be life-saving in pre-hospitals cenarios and rural under equipped centers. [2],[3],[6] In experienced hands, Magill forceps can be a useful instrument as our case demonstrates.

 
   References Top

1.Tomassi MP, Thibodeau LG. An unusual upper airway foreign body. J Emerg Med 2010;39:98-9.  Back to cited text no. 1
    
2.Soroudi A, Shipp HE, Stepanski BM, Ray LU, Murrin PA, Chan TC, et al. Adult foreign body airway obstruction in the prehospital setting. Prehosp Emerg Care 2007;11:25-9.  Back to cited text no. 2
    
3.Robson M. Magill forceps: Open or closed case? CMAJ 1987;137:369.  Back to cited text no. 3
    
4.Cetinkursun S, Sayan A, Demirbag S, Surer I, Ozdemir T, Arikan A. Safe removal of upper esophageal coins by using Magill forceps: Two centers' experience. Clin Pediatr (Phila) 2006;45:71-3.  Back to cited text no. 4
    
5.Janik JE, Janik JS. Magill forceps extraction of upper esophageal coins. J Pediatr Surg 2003;38:227-9.  Back to cited text no. 5
    
6.Baral BK, Joshi RR, Bhattarai BK, Sewal RB. Removal of coin from upper esophageal tract in children with Magill's forceps under propofol sedation. Nepal Med Coll J 2010;12:38-41.  Back to cited text no. 6
    

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Correspondence Address:
Girish Narayan
Department of Emergency Medicine, St. Johns Medical College Hospital, Bangalore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2700.130894

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