Abstract
A 48-year-old Indian man swallowed a fish bone and presented 1 week later with dysphagia, following a single episode of fresh hematemesis. A barium swallow demonstrated a horizontal mucosal tear at the level of the aortic arch, and computed tomography (CT) showed mediastinal emphysema and a bleeding point medial to the left subclavian artery which appeared to be contained by a surrounding hematoma. Subsequently, he developed sudden massive hematemesis and collapsed. Despite emergency surgery, the patient died. At the postmortem examination, a 1.2-cm fistula tract was found connecting the esophagus to the left subclavian artery. This case report emphasizes that a diagnosis of arterio-esophageal fistula should be considered if a patient presents with fresh hematemesis and a recent history of foreign body ingestion.
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References
Jackson CL (1957) Foreign bodies in the esophagus. Am J Surg 93:308–312
Barrett JH (1951) Foreign bodies in the air and food passages. Observations in one hundred eight private patients. Arch Otolaryngol 54:651–665
Nandi P, Ong GB (1978) Foreign body in the oesophagus: review of 2394 cases. Br J Surg 65:5–9
Ngan JHK, Fok PJ, Lai ECS, Branicki FJ, Wong J (1990) A prospective study on fish bone ingestion. Experience of 358 patients. Ann Surg 211:459–462
Mok CK, Chiu CSW, Cheung HHC (1989) Left subclavian arterioesophageal fistula induced by a foreign body. Ann Thorac Surg 47:458–460
Sloop RD, Thompson JC (1967) Aorto-esophageal fistula: report of a case and review of literature. Gastroenterology 53:768–777
Wu MH, Lai WW (1992) Aortoesophageal fistula induced by foreign bodies. Ann Thorac Surg 54:155–156
Bannister LH, Berry MM, Collins P, Dyson M, Dusseck JE, Ferguson MWJ (eds) (1995) Gray’s Anatomy. 38th ed. Churchill Livingstone, New York, p 1751
Ctercteko G, Mok CK (1980) Aorto-esophageal fistula induced by a foreign body. The first recorded survival. J Thorac Cardiovasc Surg 80:233–235
Wilson RT, Dean PJ, Lewis M (1987) Aortoesophageal fistula due to a foreign body. Gastrointest Endosc 33:448–450
Grey TC, Mittleman RE, Wetli CV, Horowitz S (1988) Aortoesophageal fistula and sudden death. A report of two cases and review of the literature. Am J Forensic Med Pathol 9:19–22
MacPherson RI, Hill JG, Othersen HB, Tagge EP, Smith CD 1996) Esophageal foreign bodies in children: diagnosis, treatment, and complications. AJR 166:919–924
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Leow, C.K. Subclavian arterio-esophageal fistula secondary to fish bone impaction: Report of a case. Surg Today 28, 409–411 (1998). https://doi.org/10.1007/s005950050151
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DOI: https://doi.org/10.1007/s005950050151