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Published on: July 11, 2013
Esophageal-atrial fistula resulting in systemic "meat and vegetable" emboli
M D Bell1, L G Tate, G T Hensley
1Department of Pathology, University of Miami School of Medicine, Fort Lauderdale, FL 33312.
Abstract:
An 85-year-old demented woman died in the state hospital and her death was investigated by our office, based on allegations of neglect. At autopsy, a feeding catheter was found passed through an esophageal-atrial fistula into the left atrium. Fragments of striated muscle and plant wall (cellulose) embolized to the systemic organs including heart, kidney, and brain. Her dilated esophagus suggests a premortem esophageal motility disorder that contributed to the formation of the fistula. This is the first reported case of an esophageal-atrial fistula in the medical literature.
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