Between 1997 and 2010, 18 cases of whole fish in the upper aero-digestive were managed at our institution. There were 11 men and 7 women and the age of these patients ranged from 8 to 60 years. In all cases, they tried to kill the fish by biting its head after catching it on a fishing line when the fish wriggle and slipped into the throat.Ten cases presented with acute upper airway obstruction, oropha-ryngeal bleeding and drooling of saliva mixed with blood. They were in respiratory distress, mouth wide open with neck in maximum extension. Two of them presented with severe airway obstruction, bleeding from the mouth and nose, and cyanosis which needed emergency cricothyroidectomy on arrival at the Emergency Department before taking them to the operation theatre for tracheotomy and removal of fish. Eight cases presented with drooling of saliva mixed with blood but no respiratory distress.
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