Woman with perch bone piercing esophagus and thoracic aorta

Dr. Ho Khanh Duc said this is an extremely rare accident, progresses rapidly and the mortality rate is up to more than 90% if not intervened promptly.

Doctor examines patient after recovery

Chest pain, difficulty swallowing for unknown reason

Talking to Ms. G. after the surgery, she shared that she had no idea that she had swallowed a fish bone, and in just 4 days a series of health problems befell her.

One afternoon in April, she bought 1.3 kg of perch to eat. This is a type of fish with sweet meat but many hard, sharp bones. While having lunch, she felt a little uncomfortable in her neck. She swallowed a few more mouthfuls of rice and felt a tightness in her chest. Thinking that it was because of the tiring business, she went to lie down and rest.

By the afternoon of the same day, Ms. G. felt that the pain did not subside, so she went to see a doctor and was diagnosed with gastroesophageal reflux. After two days of treatment, the chest pain and difficulty swallowing became more severe, so Ms. G. was taken by her family to a medical center in Ho Chi Minh City.

Through esophagoscopy, the doctor observed that the left wall of the esophagus was red and inflamed, and discovered a foreign object like a fish bone embedded in the esophagus. The patient then underwent a chest CT scan. The CT scan showed that the foreign object had penetrated the wall of the esophagus, and was lying close to the thoracic aortic arch. This is a large artery, if the foreign object penetrated, it could cause the patient to die from acute blood loss.

Realizing that the patient needed emergency care, the doctors urgently transferred Ms. G. to Binh Dan Hospital for treatment.

At the time of emergency admission to Binh Dan Hospital, Ms. G. had a fever, a lethargic appearance, chest pain and fatigue. Doctors determined that this was a very complicated case of a sharp foreign object penetrating the esophageal wall, puncturing the thoracic aorta. A hospital-wide consultation was immediately held for doctors from the following departments: Cardiovascular Surgery, Digestive Surgery, Digestive Endoscopy and Anesthesia and Resuscitation, in coordination with doctors from the Ho Chi Minh City Heart Institute, to perform surgery to save the patient.

Fish bone removed from patient

Dr. Ho Khanh Duc, Head of the Department of Cardiovascular Surgery, Binh Dan Hospital, the main surgeon, said: The patient is facing two major problems at the same time when the foreign object has penetrated the connective tissue, entered the mediastinum, causing mediastinitis. The risk of the foreign object puncturing the thoracic aorta causes massive blood loss leading to death. The perforated esophagus allows bacteria to enter the mediastinum, causing mediastinitis, a very serious complication that can cause death in a short time.

Therefore, doctors need to intervene quickly to perform 3 goals simultaneously in one surgery: Suturing the thoracic aortic perforation; suturing the esophageal perforation; and removing foreign objects from the patient's body.

Thanks to experience and smooth coordination, the doctors successfully achieved the above goals.

Rare disease

Dr. Nguyen Phu Huu, Deputy Head of the Department of Gastroenterology, Binh Dan Hospital, a doctor who participated in searching for foreign objects and suturing the perforated esophagus, added: “In the emergency cases of swallowing foreign objects in the digestive tract that I have performed, fish bones are the most common foreign objects. In many cases, the victim does not know that they have swallowed foreign objects. If they move down the digestive tract, foreign objects such as fish bones, toothpicks or sharp objects can penetrate the abdominal cavity, but cases where fish bones puncture the esophagus and then penetrate the muscle tissue, tearing the thoracic aorta are very rare and extremely dangerous."

Through this case, doctors recommend: When preparing food, it is necessary to remove all hard and sharp bones to avoid the risk of swallowing foreign objects. During or after a meal, especially when eating foods with hard and sharp bones, if you suddenly feel pain in the chest or abdomen, you should consider the possibility of having swallowed a bone. When you know you have swallowed a foreign object, you need to go to a medical facility immediately for timely and effective treatment. Patients should not try to swallow more food or drink water to "wash it down" because there is a risk of damaging the digestive tract, leading to infection and dangerous complications.

Source link: https://thanhnien.vn/nguoi-phu-nu-bi-xuong-ca-ro-xuyen-thung-thuc-quan-va-dong-mach-chu-nguc-185230517134506255.htm