Abstract
A 17-year-old male presented to our ED complaining of pain and swelling at the base of the first metacarpal after attempting to remove a catfish from his fishing line 12 hours prior to arrival. Radiographic images demonstrated a foreign body (FB), which was detectable by ultrasound. Hand surgery was consulted and took the patient to the operating room for exploration and removal of two serrated radiopaque catfish spines that were deeply embedded in the left thumb. Conclusion. Penetrating injury from hardhead catfish (Ariopsis felis) spines can cause hidden FB, envenomation, infection, and secondary damage to nearby structures. Imaging should be done for these patients to ensure they obtain timely and complete extraction of the venomous structures. Surgery should be consulted for operative management to avoid damage on removal of the catfish spine remnants.
Highlights
The saltwater catfish is more formally known as the hardhead catfish (Ariopsis felis)
Soft tissue swelling or gas may be the only sign of a foreign body especially with smaller fragments and with some species of fish bones which may not be adequately radiopaque [7, 8]
There are several independent factors that play a role in the ability to identify a foreign body (FB) on ultrasound
Summary
The saltwater catfish is more formally known as the hardhead catfish (Ariopsis felis). They are considered a nuisance to fisherman since they are attracted to most types of bait and are often accidentally caught despite their undesirable taste They have six long barbels surrounding their mouth and chin to help them catch prey and sharp, serrated, mucous-covered pectoral, and dorsal spines. The venom can be neutralized by immersing the wound in a warm water bath for 30 minutes but is most concerning due to its high association with secondary infections, especially in immunocompromised patients [2, 3] Puncture wound by these spines can penetrate and is serrated such that they can be very difficult and even damaging if not removed appropriately. There have been only a few case reports in specialty journals reporting these injuries, including a penetrating renal injury and punctures to the feet and hand [2,3,4,5,6]
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