Combined Minimally Invasive Treatment of Delayed Aortoesophageal Fistula Caused by Fishbone.

Aortoesophageal fistula caused by esophageal foreign body is a rare, catastrophic condition. We report a case of delayed aortoesophageal fistula caused by fishbone and associated with severe hematemesis, mediastinal abscess, and esophageal tear. We performed thoracic endovascular aortic repair to control the bleeding and video-assisted thoracoscopic surgery to drain the mediastinal abscess and to repair the esophageal tear. The patient recovered with limited physical and physiologic impairment after systematic treatment. This case highlights the feasibility of combined thoracic endovascular aortic repair and video-assisted thoracoscopic surgery as an optimum management strategy in cases of aortoesophageal fistula associated with severe bleeding and mediastinal abscess.