Esophagoaortic perforation by foreign body (coin) causing sudden death in a 3-year-old child

We report an extremely unusual consequence to foreign body ingestion in a c ase of a 3-year-old boy who died suddenly and at autopsy was found to have an esophagoaortic fistula. This fistula was caused by a coin which lodged p osteriorly and eroded through the esophagus into the aorta. Serious complic ations following foreign body ingestion are rare and include stricture form ation, intramural abscess, and the formation of fistula tracts. This case i llustrates the potentially unpredictable behavior of impacted foreign bodie s. The child's parents were initially suspected of child abuse based on the terminal hemoptysis.