A Case of Esophageal Penetration of a Fish Bone into the Left Atrium Rescued by Urgent Surgery

Esophageal penetration due to accidental foreign body ingestion is relatively rare but has a poor prognosis. Penetration into the left atrium is extremely rare, and only a few cases have been reported. A case of foreign body penetration into the left atrium is reported.

The patient was a 75-year-old woman who was transferred to our hospital for surgery due to fish bone perforation from the lower esophagus into the left atrium on CT. Urgent surgery was performed with the diagnosis of sepsis due to a mediastinal abscess and esophageal penetration into the left atrium caused by accidental fish bone ingestion. At surgery, only the fistula of the penetration wound in the esophagus and the left atrium could be detected, but not the fish bone. On CT after surgery, a folded fish bone was seen at the pericardium close to the left atrium. It was considered unlikely that the heart would again be perforated due to the fish bone's length, and it was decided to follow up with continued antimicrobial therapy.

A rare, successfully rescued case of esophageal penetration of an accidentally ingested fish bone into the left atrium by urgent surgery, with collaboration between gastrointestinal and cardiovascular surgeons, is reported.