Thoracoscopic retrieval of a rare migrated fish bone in the thorax: a case report with sequential CT evidence and literature review

Esophageal foreign bodies represent a common clinical emergency. Sharp foreign bodies, such as fish bones, carry a risk of esophageal perforation and subsequent severe complications. Extraluminal migration into the thoracic cavity is an uncommon but clinically significant occurrence. A 58-year-old male presented with a 6-hour history of fish bone ingestion. Initial chest computed tomography (CT) demonstrated an esophageal foreign body with associated perforation; however, rigid esophagoscopy was unsuccessful in localizing the object. Follow-up contrast-enhanced CT revealed migration of the foreign body into the thoracic cavity posterior to the left subclavian artery, accompanied by left-sided pneumothorax and 80% lung compression. Single-port thoracoscopic surgery performed 28 h post-admission successfully retrieved a 2.5-cm fish bone and addressed the pulmonary injury. The patient recovered without complications, and follow-up imaging confirmed no delayed sequelae. Sequential CT imaging facilitates accurate localization of migrated foreign bodies, while minimally invasive thoracoscopic techniques provide an effective therapeutic option. Multidisciplinary collaboration and imaging-guided clinical decision-making play a critical role in minimizing complications and optimizing outcomes.