A case report highlights the lifesaving impact of TEVAR and multidisciplinary strategies in managing aortic penetration by an esophageal foreign body.
Abstract Background Thoracic aortic penetration by an esophageal foreign body (EFB) is a rare, fatal emergency (> 80% mortality). This case demonstrates a standardized multidisciplinary approach emphasizing prophylactic thoracic endovascular aortic repair (TEVAR) for hemorrhage prevention. Case presentation A 57-year-old woman developed retrosternal pain after fish ingestion. Computed tomography confirmed a fish bone penetrating the esophagus into the aortic arch lumen. Under multidisciplinary coordination: a covered stent was pre-positioned endovascularly; rigid esophagoscopy extracted the barbed bone; immediate TEVAR sealed aortic leakage post-removal. Postoperative management included dual antibiotics and antiplatelet therapy. Three-month follow-up showed intact stent without complications. Conclusions Prophylactic TEVAR prior to EFB removal is lifesaving in aortic-penetrating injuries, preventing catastrophic hemorrhage in stable patients. This integrated cardiothoracic-otolaryngology protocol offers a replicable model for managing this lethal condition.
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Xue et al. (2025) studied this question.
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