Clinical Innovation At Apollo

 When 30 years age of young man reached the Department of Emergency of Apollo Hospitals Bhubaneswar with respiratory distress, pain and bleeding from the throat, he was instantly taken into care by the Team as he was writhing in pain.

Later it came to knowledge from the relatives accompanying the patient that one live fish had accidentally gone into his throat while he was fishing.

In fact he  was holding the fish near his mouth and was calling someone, the fish wriggled and went straight into his mouth and got stuck in the throat.

They first rushed to the nearest hospital where the doctors tried to remove the fish but in vain.

He was later shifted to medical college hospital where an x-ray was conducted before he decided to come to Apollo Hospitals. 

On examination there were lacerations inside the throat and some part of the tail of the fish was visible through the mouth.

The movement of the fish made the pain acute and the patient was experiencing severe breathing difficulty and frequent coughing.

Patient  was even unable to talk and was vomiting blood due to the movement of the fish causing more injury to the oropharynx. His oxygen saturation was decreasing.

 X-ray neck lateral view demonstrated the head of the fish was stuck in the cricopharynx and the body was compressing the laryngeal inlet .

The patient was immediately shifted to the emergency operation theatre. Intravenous line was secured and Injection Hydrocortisone 100 mg i.v was given to reduce the airway edema.

Team Apollo have prepared the patient for tracheostomy under local anaesthesia. The patient was unable to lie down as there was severe pain and distress.

 In the sitting position the local anaesthetic spray was given. Mild sedation was given to relieve the anxiety. Boyle Davis mouth gag was applied.

As only the tail was visible partially we held it with the Allis forceps and applied gradual traction.

Then some more part of the fish was visible which was grasped by a sponge holder. Team Apollo continued the traction and the fish finally came out in one piece.

 After the removal of fish, the oropharynx and laryngopharynx was examined with a direct laryngoscope for any remnant. It was severely lacerated but there was no remnant. The length of the fish was 11 cm and the width was 4 cm.

The patient was relieved from pain and distress immediately after removal. He was discharged under stable condition after one day of hospitalization.

Ryle’s tube was placed and feeding was given for 10 days. The tube was removed after the stipulated and the lacerations were healed completely.

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