[Aorto-esophageal fistula caused by swallowed foreign body (report of 17 cases)].

Seventeen cases of aorto-esophageal fistula (AEF) induced by foreign bodies (Fb) were reported. Ingested fish and chicken bones were the most frequent offending agents (15 cases). The objects were lodged at the level of the aortic arch. It is those arrested in this region that may penetrate the esophageal wall and cause an AEF. The average latent period between the time of swallowing the FB and the signal of hemorrhage was about 8 days. A signal of hemorrhage preceding the exsanguinating episodes had been present in 14 cases. This can be taken as the indication for urgent operation. Early diagnosis of AEF can be made by the history alone, Esophagoscopy may invite a sudden death from massive hemorrhage once an AEF is already present. In a small number of cases, an aortic false aneurysm or an esophago-bronchial fistula can produce respiratory symptoms without hematemesis, Mediastinal widening on chest X-ray films usually suggests a false aneurysm but it must be differentiated from a mediastinal abscess or a tumor mass. Of these 17 patients, 11 were treated conservatively and all died. Six patients were treated surgically with 5 deaths and one surgical survivor. This case is believed to be the third reported surgical survival.