Do foreign bodies migrate through the body towards the heart?
Fixation of foreign bodies (FB), in the mucosa, can favor its migration, giving origin to the popular saying: 'FB walk to the heart'.


OBJECTIVE
Describe the mechanisms involved in FB migration and how to diagnose them.


METHODS
From a sample of 3,000 foreign bodies, during 40 years, we analyzed four which had extra-lumen migration. We analyzed clinical, radiologic, endoscopic and ultrasound data collected at the medical documentation service.


RESULTS
Three clinical histories are presented, describing two fish bones and one piece of fish cartilage. FB shifting was analyzed in all of them. Migration started in the esophagus in two, one going to the aorta and the other to the neck area. In the other two, migration started in the pharynx, and the FB moved towards the prevertebral fascia and the other externalized in the submandibular region. The mechanisms and the risks posed to the patient, by FB migration, and the way to diagnose them are hereby discussed.


CONCLUSIONS
The study allows us to determine that FB can move through the body but not towards the heart. The study also serves as a warning sign: in cases of prolonged histories of FB ingestion, imaging studies are mandatory before endoscopic examination.
Mamede
Rui Celso Martins
RC
Department of Ophthalmology, HCFMRP-USP. rcmmamed@fmrp.usp.br
Amaral
Fabiana do
Fd
Raimundo
Daniel Garcia
DG
Freitas
Luiz Carlos Conti de
LC
Ricz
Hilton M A
HM
Mello Filho
Francisco V
FV
D000328:Adult; D004947:Esophagus / Q000000981:diagnostic imaging; D005260:Female; D005336:Fiber Optic Technology; D005548:Foreign-Body Migration / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006321:Heart; D006801:Humans; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed