Fish bone from an Unagi (Eel) meal stuck in the throat? You might be surprised!

Recently, Dr Gan was called to the Accident and Emergency Department at Mount Elizabeth Novena Hospital late at night to see a patient, Ms A, who complained of sore throat after eating some Unagi (Eel) with rice at a local Japanese restaurant. She experienced a sharp poking sensation on the left side of her throat and neck region which was worse on swallowing.

On examination, there was an approximately 1.5 cm curvilinear transparent Unagi bone stuck in her left tonsil. This was removed with a pair of forceps with immediate relieve of her symptoms.

Small transparent Unagi bone that was removed from Ms A’s left tonsil

Unagi is a freshwater eel that is often served in Japanese restaurants. It is most commonly served as a grilled eel fillet (coated with a sweet sauce) with rice (Unadon or “eel bowl”) or as a sushi wrapped in rice and cucumber (Unakyu). Most people eating Unagi will never think about the possibility of bones that may get stuck in the throat. Although the filleted eel is deboned, there can still be many fine tiny bones in an unagi. Most of the time, these fine bones are harmless if swallowed. However, there are occasions where there are larger bones left in the Unagi that should not be swallowed. Hence, it is best to avoid putting fish with rice in your mouth as it makes it more difficult to dissect out any leftover bones in the fish. Ms A was fortunate that her bone was embedded in her left tonsil which was easily accessible by Dr Gan.

Common sites where fish bones get stuck in the throat include the tonsils, back of the tongue (near the voice box region) and the food pipe (esophagus).  Fish bone stuck in the tonsils can be removed by a General Practitioner or by an Accident & Emergency Doctor. For bones that are stuck deeper in the throat (e.g. at the back part of the tongue) or in the food pipe (esophagus), these need to be removed by an ENT Specialist.