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Visualization of Ingested "Neck Bones" on CT
General Considerations
- Neck bones provide an inexpensive seasoning to stocks, soups, beans and boiled greens
- Usually found in African-American, Italian, Asian or Caribbean dishes
- May be turkey, pork or beef neck bones
- Some use the bones for flavor, others eat the meat just as "ribs" are eaten and others chew and ingest the bones themselves, which are small and become soft in cooking
- Ingestion can either be accidental or intentional
- The risk of bowel perforation from an ingested foreign body depends on its size and sharpness
- These bones tend to be short and soft
- Foreign body perforations occur
- More commonly in elderly who wear dentures
- Those with mental impairment
- In chronic alcohol abuse
Clinical Findings
- Our cases were asymptomatic
- Colonic and small bowel perforation can occur from the ingestion of chicken bones
- Most foreign body perforations occur in the ileum, then cecum and left colon
- There have been reports of ingested fish and poultry bones causing anal pain
Imaging Findings
- Calcific structures of bone density having a denser outer cortex and less dense medullary space
- Found within bowel
- Usually multiple in number
Treatment
Two different patients with CT visualization of ingested "neck bones." In both cases there are numerous
short foreign bodies of bone density with a clear outer cortex (yellow and white arrows above and yellow and blue arrows below). There is a bone in the region of the pyloroduodenal junction below.
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Radiologic–Pathologic Conferences of the Massachusetts General Hospital. Colonic Perforation by Ingested Chicken Bone. Amjad A. Rasheed, Vikram Deshpande, Priscilla J. Slanetz. 152 AJR:176, January 2001.
Acute abdomen caused by ingested chicken wishbone: a case report. Faton T Hoxha, Shemsedin I Hashani, Driton S Komoni, Lumturije H Gashi-Luci, Fisnik I Kurshumliu, Medita SH Hashimi and Avdyl S Krasniqi. Cases Journal 2009, 2:64 doi:10.1186/1757-1626-2-64.
Quirk Books: www.quirkbooks.com
Wikipedia-Neck bones
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