A Fish Bone Penetrating the Esophagus Into the Left Atrium

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Fish bone migration into the left atrium (n=1). Intervention: Emergency surgery under cardiopulmonary bypass. Primary outcome: Clinical recovery and cardiac function.

Q: What does this research mean for the field?

Fish bone perforation migrating from the esophagus into the left atrium can be successfully resolved through prompt computed tomography diagnosis and emergency surgical intervention with cardiopulmonary bypass. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Yinghong Chen; Shuiwei Qiu; Lin Chen; Shufeng Xu; Yifan Jiang; Tao Zhu; Min Zhou

doi:10.1016/j.jaccas.2026.110743

October 1, 2026JACC Case ReportsOpen Access

A Fish Bone Penetrating the Esophagus Into the Left Atrium

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Key result

Emergency cardiopulmonary bypass surgery successfully manages penetrating left atrial fish bone foreign body.

n=1

Graphical abstract published by JACC Case Reports — Graphical abstract · Published by JACC Case Reports · CC BY-NC-ND 4.0

Why the study?

Fish bone migration into the left atrium is extremely rare and carries high mortality, requiring detailed diagnostic and management strategies.

Key Points

Describe the clinical presentation, diagnosis, and surgical management of a rare, life-threatening esophageal perforation extending into the left atrium caused by a swallowed fish bone.
Evaluated a 68-year-old female presenting with chest pain, fever, and dyspnea using contrast-enhanced computed tomography and transthoracic echocardiography.
Performed emergency foreign body extraction under cardiopulmonary bypass with abscess debridement, atrial wall repair, and esophageal drainage.
Imaging revealed a 2.9-cm linear foreign body traversing the mid-esophagus into the left atrium with an associated 2.3-cm intracardiac echogenic mass.
Emergency surgical extraction and repair resulted in uneventful recovery, hospital discharge on postoperative day 12, and normal cardiac function without complications at 1-month follow-up.

Study Design

Type

Case Report (n=1)

Structured PICO

P

Population

A 68-year-old woman who swallowed a fish bone presenting with left atrial penetration, treated surgically and followed for 1 month.

I

Intervention

Emergency surgery under cardiopulmonary bypass (extraction of fish bone, debridement of vegetation and abscess, atrial wall repair, drainage of esophageal perforation) and prolonged antibiotics.

O

Outcome

Clinical recovery and cardiac function at 1-month follow-up.

Implication

Prompt diagnosis with computed tomography and emergency surgical management under cardiopulmonary bypass can successfully treat the extremely rare and life-threatening migration of a fish bone into the left atrium.

Abstract

BACKGROUND: Fish bone migration into the left atrium is extremely rare and carries high mortality. CASE SUMMARY: A 68-year-old woman presented with chest pain, fever, and dyspnea 5 days after swallowing a fish bone; she had attempted to dislodge it with a rice ball. Contrast-enhanced computed tomography showed a 2.9-cm linear foreign body penetrating the mid-esophagus into the left atrium. Transthoracic echocardiography revealed a 2.3-cm echogenic mass in the left atrium without pericardial effusion. Emergency surgery under cardiopulmonary bypass extracted the fish bone, debrided a large vegetation and abscess, repaired the atrial wall, and drained the esophageal perforation. She recovered uneventfully and was discharged on day 12. At 1-month follow-up, cardiac function was normal, and no complications occurred. CONCLUSION: This case illustrates the "pump-saw" mechanism and the diagnostic value of computed tomography. Successful management requires multidisciplinary teamwork, standby extracorporeal circulation, and prolonged antibiotics.

Discussion

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Cite This Study

Chen et al. (2026) conducted a case report in Fish bone migration into the left atrium (n=1). Emergency surgery under cardiopulmonary bypass was evaluated on Clinical recovery and cardiac function. Emergency surgery under cardiopulmonary bypass successfully managed a fish bone penetrating the left atrium, resulting in normal cardiac function and no complications at 1 month.

synapsesocial.com/papers/6ad34de0727baf805bb60e98 https://doi.org/10.1016/j.jaccas.2026.110743

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A Fish Bone Penetrating the Esophagus Into the Left Atrium

Key Points

Study Design

Structured PICO

Implication

Abstract

Discussion

Cite This Study

A Fish Bone Penetrating the Esophagus Into the Left Atrium

Key Points

Study Design

Structured PICO

Implication

Abstract

Discussion

Cite This Study

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