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Eur J Cardiothorac Surg 2007;31:946-948. doi:10.1016/j.ejcts.2007.01.073
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Case reports

Aortoesophageal perforation following ingestion of razorblades with massive haemothorax

Ian Hunta,*, Sarah Hartleyb, Yasir Alwahabb, Guy J. Birkillc

a Department of Cardiothoracic Surgery, St. George's Hospital, Blackshaw Road, London SW17 0QT, UK
b Department of Cardiothoracic Surgery, Royal Sussex County Hospital, Brighton, UK
c Department of Radiology, Royal Sussex County Hospital, Brighton, UK

Received 31 October 2006; received in revised form 24 January 2007; accepted 29 January 2007.

* Corresponding author. Tel.: +44 208 727200; fax: +44 208 7250211. (Email: ianjhunt{at}gmail.com).

Aortoesophageal fistula is a rare complication of foreign body ingestion. Typically having ingested a fish or chicken bone, the patient complains of chest pain or discomfort and/or may present with massive gastrointestinal bleeding, which in all but rare cases is fatal. The pathological mechanism may involve perforation and direct communication of oesophagus and aorta usually at the level of the aortic arch; or more usually following oesophageal perforation, the subsequent mediastinal abscess leads to necrosis of the aortic wall. Torrential haemothorax as a result of such a process has not been previously described, though it has undoubtedly occurred. We present a case of massive haemothorax following deliberate ingestion of razorblades that highlights clinically and radiologically the natural course of such a tragic action.

Key Words: Oesophageal perforation • Mediastinitis • Aortoesophageal fistula • Tamponading haemothorax






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Copyright © 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.