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[A fatal aorto-esophageal fistula due a foreign body: a foreseeable accident?]
1Service de Chirurgie générale et transplantation hépatique, Hôpital de La Conception, Marseille.
Background:
The ingestion of foreign bodies is the second most frequent cause of aorto-esophageal fistulization after aneurysms of the thoracic aorta.
Case Report:
A 28-year-old man died from catastrophic hematemesis 7 days after ingesting a bone splinter. The CT scan performed 3 days before the fatal event had demonstrated a fistulous formation originating in the aorta.
Discussion:
Aorto-esophageal fistulae develop progressively from the esophageal perforation caused by the foreign body. Clinically, there is medical chest pain, followed by arterial hematemesis and finally terminal exsanguination. Diagnosis must be achieved during the free intervals in this triad of often rapidly succeeding signs.