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Rupture of Ascending Aorta Secondary to Esophageal Perforation by Fish Bone

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Perforations of both esophagus and aorta after swallowing foreign bodies have been described, with aorto-esophageal fistulas at the level of the descending aorta or aortic arch. We present the case of a 48-year-old man with esophageal perforation by fish bone, mediastinitis, and evidence of perforation of the ascending aorta during surgical drainage of the mediastinum. At autopsy, a fish bone was found under the aortic arch. Serial histological macrosections of the mediastinic block allowed reconstruction of the type of injury suffered and a thorough analysis of mediastinic structures, with preservation of topographic relationships. Direct demonstration of the perforation of the posterior wall of ascending aorta was provided. Histological examination ascribed aortic perforation to migration of the fish bone and direct injury. This is the first anatomical and pathological study of an autopsy case of perforation of the ascending aorta by fish bone.
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Keywords: endovascular stent; esophageal perforation; foreign body ingestion; forensic pathology; forensic science; histological macrosection; morphological findings; vascular injury

Document Type: Research Article

Affiliations: 1: Department of Human Anatomy and Physiology, University of Padova, Via Gabelli 65, 35127 Padova, Italy. 2: Department of Surgical and Gastroenterological Sciences, University of Padova, Via Giustiniani 2, 35127 Padova, Italy. 3: Department of Oncological and Surgical Sciences, University of Padova, Via Gabelli 61, 35127 Padova, Italy.

Publication date: September 1, 2008

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