Double Trouble: Bilateral Fishbone Perforation and Its Successful Retrieval

Fishbones are a common aerodigestive foreign body because of their irregular shape and the complex anatomy of the throat and esophagus. They are usually lodged in the upper esophagus and may sometimes cause severe complications. We present a 61-year-old man with dysphagia and chest discomfort 8 days after eating fish. CT imaging revealed a fishbone horizontally lodged across the esophagus with bilateral perforation into the mediastinum. Endoscopic removal was successfully performed under surgical standby. This case highlights a rare bilateral perforation, emphasizing the importance of CT imaging, multidisciplinary coordination, and creative endoscopic management.