title: A fish way out of water: case report of a unique airway foreign body.
abstract: BACKGROUND
  Since the time of Chevalier Jackson, innumerable unique foreign bodies have been documented and removed. Advances in endoscopic airway management have revolutionized the types of foreign bodies that we are able to remove without open surgery. The literature on fish aspiration has mostly encompassed fish bones and parts, not whole live fish.
  
  
  OBJECTIVE
  This study aimed to describe the airway management of a high-risk airway foreign body including the mobilization and coordination of multiple specialty teams and anesthetic management.
  
  
  METHODS
  We report a case of a 40-year-old man who aspirated a live bluegill fish while attempting to use it as bait. The spike-like nature of the bluegill dorsal fin in conjunction with mediastinal air prompted a higher level of concern for potential airway compromise and complication with extraction. We detail the preparation and management of this patient from notification to transportation and ultimately operative intervention. Focus is placed on coordination between anesthesia, otolaryngology, and cardiothoracic surgery, and the key management decisions.
  
  
  CONCLUSIONS
  High-risk airway foreign bodies are always a challenge. When dealing with a live, lodged whole fish, one must have creative management ideas. Close coordination and excellent communication must occur between teams involved to optimize and maintain control of the situation for the best patient outcome.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Gantwerker
authors.forename: Steven S
authors.initials: SS
authors.lastname: Hamilton
authors.forename: Keith A
authors.initials: KA
authors.lastname: Casper
mesh_terms: D000328:Adult; D000818:Animals; D001980:Bronchi; D005399:Fishes; D005547:Foreign Bodies / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male
keywords: airway control; airway management; airway obstruction; bronchoscopy/methods; foreign bodies/surgery