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Case Reports
. 2020 Oct 2;15(1):292.
doi: 10.1186/s13019-020-01325-6.

Aortic penetration due to a fish bone: a case report

Daming Jiang  1 , Yi Lu  2 , Yigong Zhang  3 , Zhanglong Hu  3 , Haifeng Cheng  3
Affiliations
Case Reports

Aortic penetration due to a fish bone: a case report

Daming Jiang et al. J Cardiothorac Surg. .

Abstract

Background: Aortoesophageal fistula (AEF) caused by an esophageal foreign body is a life-threatening crisis, with rapid progress and high mortality. The first case of AEF was reported in 1818, but the first successfully managed case was not until 1980. Although there have been some reports on this condition, in most cases, the aorta was invaded and corroded due to its adjacent relationship with the esophagus and subsequent mediastinitis. To date, few reports have described an aortic wall directly penetrated by a sharp foreign body, likely because this type of injury is extremely rare and most patients cannot receive timely treatment. Here, we present a rare case of a fish bone that directly pierced the aorta via the esophagus.

Case presentation: A 31-year-old female experienced poststernum swallowing pain after eating a meal of fish. Gastroscope showed a fishbone-like foreign body had penetrated the esophagus wall. Computed tomography revealed that the foreign body had directly pierced the aorta to form an AEF. Surgery was successfully performed to repair the aorta and esophagus. The postoperation and follow-up was uneventful.

Conclusions: For the treatment of foreign bodies in the esophagus, we should be alert of the possibility of AEFs. The effective management of AEFs requires early diagnosis and intervention, as well as long-term treatment and follow-up, which still has a long way to go.

Keywords: Aortic infection; Aortic penetration; Aortoesophageal fistula; Case report; Esophageal foreign body; Esophageal perforation; Mediastinitis; Surgery; Thoracic endovascular aortic repair.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a A typical picture of gastroscopy demonstrats the fish bone (arrow) piercing into the esophagus wall; b A CT shows a fish bone (arrow) in esophagus piercing directly into the thoracic aorta. c Fish bone (arrow) piercing from esophagus into the aorta (Intraoperative vision). d Fish bone after removal
Fig. 2
Fig. 2
Intraoperative picture shows the operative procedure (the circle presenting the fish bone)
See this image and copyright information in PMC

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