Aortic penetration due to a fish bone: a case report

Journal of Cardiothoracic Surgery

Yi Lu¹  Yigong Zhang²  Zhanglong Hu²  Haifeng Cheng²  Daming Jiang² 

[1] Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China;Department of Cardiovascular Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, 88 JieFang Road, 310009, Hangzhou, P.R. China;

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

DOI  :  10.1186/s13019-020-01325-6

来源: Springer

【 摘 要 】

BackgroundAortoesophageal 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 presentationA 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.ConclusionsFor 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.

【 授权许可】

CC BY