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Updated: Oct 17, 2026

Murine Echocardiography of Left Atrium, Aorta, and Pulmonary Artery
Published on: February 20, 2017
A Fish Bone Penetrating the Esophagus Into the Left Atrium
Yinghong Chen1, Shuiwei Qiu1, Lin Chen1
1Department of Cardiac Surgery, Quzhou People's Hospital, The Quzhou Affiliated Hospital, Wenzhou Medical University, Quzhou, Zhejiang, China.
Background:
Fish bone migration into the left atrium is extremely rare and carries high mortality.
Case Summary:
A 68-year-old woman presented with chest pain, fever, and dyspnea 5 days after swallowing a fish bone; she had attempted to dislodge it with a rice ball. Contrast-enhanced computed tomography showed a 2.9-cm linear foreign body penetrating the mid-esophagus into the left atrium. Transthoracic echocardiography revealed a 2.3-cm echogenic mass in the left atrium without pericardial effusion. Emergency surgery under cardiopulmonary bypass extracted the fish bone, debrided a large vegetation and abscess, repaired the atrial wall, and drained the esophageal perforation. She recovered uneventfully and was discharged on day 12. At 1-month follow-up, cardiac function was normal, and no complications occurred.
Conclusion:
This case illustrates the "pump-saw" mechanism and the diagnostic value of computed tomography. Successful management requires multidisciplinary teamwork, standby extracorporeal circulation, and prolonged antibiotics.
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