SUBCLAVIAN ARTERIO-ESOPHAGEAL FISTULA SECONDARY TO FISH BONE IMPACTION - REPORT OF A CASE

A 48-year-old Indian man swallowed a fish bone and presented 1 week la ter with dysphagia, following a single episode of fresh hematemesis. A barium swallow demonstrated a horizontal mucosal tear at the level of the aortic arch, and computed tomography (CT) showed mediastinal emph ysema and a bleeding point medial to the left subclavian artery which appeared to be contained by a surrounding hematoma, Subsequently, he d eveloped sudden massive hematemesis and collapsed, Despite emergency s urgery, the patient died, At the postmortem examination, a 1,2-cm fist ula tract was found connecting the esophagus to the left subclavian ar tery, This case report emphasizes that a diagnosis of arterio-esophage al fistula should be considered if a patient presents with fresh hemat emesis and a recent history of foreign body ingestion.