A Woman Accidentally Swallowed a Fish Bone and It Pierced Her Aorta

A Woman Accidentally Swallowed a Fish Bone and It Pierced Her Aorta
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A woman's fish dinner almost turned fatal when a bone she accidentally swallowed cut through her esophagus and pierced her aorta just above the heart.

Doctors from Zhejiang University School of Medicine in Hangzhou, China recently described the incident in the Journal of Cardiothoracic Surgery.

After eating her meal, the 31-year-old began experiencing severe pain when swallowing. She visited the hospital two days later. A CT scan revealed a sharp object that slashed through her esophagus to lodge in her aorta, just above the heart. The aorta is the largest artery in the body, running from the heart down to the lower abdomen.

A: The fish bone (arrow) piercing into the esophagus wall; B: CT shows a fish bone (arrow) in esophagus piercing directly into the thoracic aorta. C: Fish bone (arrow) piercing from esophagus into the aorta. D: Fish bone after removal

As a result of the injury, blood was leaking from the woman's aorta into her esophagus. This is called a aortoesophageal fistula (AEF) and it is deadly in roughly half of cases. With an AEF, the aorta will eventually rupture, filling the esophagus with blood and causing the victim to vomit profusely and eventually bleed out.

Luckily for the 31-year-old, doctors swiftly performed emergency surgery after diagnosing her situation. They removed the fish bone, sutured the holes in the aorta and esophagus, and drained her chest cavity of blood. It's been five years since the incident and the woman has been free of complications.

Source: Jiang, D., Lu, Y., Zhang, Y. et al. "Aortic penetration due to a fish bone: a case report". J Cardiothorac Surg 15, 292 (2020). https://doi.org/10.1186/s13019-020-01325-6

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