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Three Part Question

In [patients who are suspected to have fish or chicken bones impacted in the oesophagus] is [computerised tomography more effective] than [plain radiography at diagnosis]?

Clinical Scenario

A 60 year old man attends the ED complaining that a fish bone has got stuck in his throat. Clinical examination rules out impaction within the pharynx so you are concerned that the bone has become impacted within the oesophagus. Prior experience tells you that oesophageal abrasions secondary to ingested bones can often mimic impaction, that rigid oesophgoscopy (the definitive investigation) carries a significant mortality and morbidity rate, and that the most readily available non-invasive investigations, lateral neck and chest x-rays, are often unreliable. You wonder whether a CT scan of the neck would be a more accurate non-invasive tool?

Search Strategy

Medline 1966 – week 3, February 2006. Limit to human and English.