[Lethal bleeding after accidental swallowing of a wooden meat skewer]

Fistulas into the large vessels are a rare cause of intestinal bleeding. In some cases they are caused by transmural perforation after the accidental swallowing of a sharp foreign body like a bone or a fish bone. We report about a 79-year-old patient who had swallowed a fragment of a wooden meat skewer which induced a perforation of the oesophagus and aorta walls. The patient was admitted to the hospital with signs of severe gastrointestinal bleeding. The emergency endoscopic examination confirmed the cause of the bleeding, but the patient died during the intervention from haemorrhagic shock. The forensic autopsy confirmed the clinical suspicion of an aorto-oesophageal fistula.