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Massive upper gastrointestinal bleeding due to esophago- thyroidal artery fistula following foreign body aspiration: a case report

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Author(s): Bagheri R. | Maddah Gh. | Abdollahi A.

Journal: Tehran University Medical Journal
ISSN 1683-1764

Volume: 65;
Issue: 8;
Start page: 91;
Date: 2007;
Original page

Keywords: Esophageal foreign body | gastrointestinal bleeding | esophageo-thyroidal artery fistula

ABSTRACT
Background: Immediate treatment when an esophageal foreign body is suspected is critical because of the possibility of serious complications. The presence of foreign bodies in the esophagus usually occurs accidentally in children and mentally retarded adults. A greater risk of perforation of the esophagus, development of a mediastinal, as well as airway compromise is present when a foreign body is lodged longer than 24 hours. Furthermore, this condition results in complications, such as hemorrhage or esophageal fistula, when treatment is delayed. We herein report a case of esophageo-thyroidal artery fistula, a rare complication resulting from the delayed removal of an esophageal foreign body. Patient presentation: A 34 year-old female who had swallowed her dental prosthesis one week previously was referred for severe gastrointestinal bleeding. Surgery to remove the foreign body was performed. To determine the cause of continued bleeding after the endoscopy and angiography, we performed a neck exploration, which revealed hemorrhage from a fistula between thyroid vessels and the esophagus. After surgical resection of the fistula, the patient was discharged from the hospital in good condition and has had no related problems for six months.Conclusions: Considering the complications resulting from the delay of the removal of foreign bodies from the esophagus, these objects should be removed as soon as possible.
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