Esophageal-atrial fistula resulting in systemic "meat and vegetable" emboli.
An 85-year-old demented woman died in the state hospital and her death was investigated by our office, based on allegations of neglect. At autopsy, a feeding catheter was found passed through an esophageal-atrial fistula into the left atrium. Fragments of striated muscle and plant wall (cellulose) embolized to the systemic organs including heart, kidney, and brain. Her dilated esophagus suggests a premortem esophageal motility disorder that contributed to the formation of the fistula. This is the first reported case of an esophageal-atrial fistula in the medical literature.
Bell
M D
MD
Department of Pathology, University of Miami School of Medicine, Fort Lauderdale, FL 33312.
Tate
L G
LG
Hensley
G T
GT
D000368:Aged; D000369:Aged, 80 and over; D004617:Embolism / Q000209:etiology*; D004750:Enteral Nutrition / Q000009:adverse effects*; D004937:Esophageal Fistula / Q000209:etiology*; D005260:Female; D005402:Fistula / Q000209:etiology*; D005502:Food; D006325:Heart Atria; D006331:Heart Diseases / Q000209:etiology*; D006801:Humans