title: Rupture of ascending aorta secondary to esophageal perforation by fish bone.
abstract: 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.
authors.affiliation: Department of Human Anatomy and Physiology, University of Padova, Padova, Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Macchi
authors.forename: Andrea
authors.initials: A
authors.lastname: Porzionato
authors.forename: Romeo
authors.initials: R
authors.lastname: Bardini
authors.forename: Anna
authors.initials: A
authors.lastname: Parenti
authors.forename: Raffaele
authors.initials: R
authors.lastname: De Caro
mesh_terms: D000818:Animals; D001011:Aorta / Q000293:injuries* / Q000473:pathology; D001019:Aortic Rupture / Q000209:etiology / Q000473:pathology*; D001842:Bone and Bones / Q000473:pathology*; D004939:Esophageal Perforation / Q000150:complications / Q000209:etiology / Q000473:pathology*; D005399:Fishes; D005548:Foreign-Body Migration / Q000150:complications / Q000473:pathology*; D049429:Forensic Pathology; D006470:Hemorrhage / Q000209:etiology / Q000473:pathology; D006801:Humans; D008480:Mediastinitis / Q000209:etiology / Q000473:pathology; D008875:Middle Aged