Pehlivan Sultan, Kara Dogus Ozdemir, Turkkan Dilhan, Akçan Ramazan, Gokmen Asude, Akduman Baris, Karapirli Mustafa
Ankara Branch of the Council of Forensic Medicine, Ankara, Turkey.
Ankara Branch of the Council of Forensic Medicine, Ankara, Turkey.
J Forensic Leg Med. 2014 Feb;22:112-4. doi: 10.1016/j.jflm.2013.12.020. Epub 2013 Dec 20.
Esophageal foreign body ingestion is especially frequent in childhood and may cause fatal complications in case of late diagnosis and delayed treatment. We present a case of 2-year old girl who was admitted to emergency department with massive bleeding. However, she died due to an unrecognized foreign body resulted an aorto-esophageal fistula. At autopsy an aorto-esophageal fistula was detected by gross examination. Tissue samples were obtained from the organs and fistula region. In histopathological examination, a calcified body with multinucleated giant cell and surrounding granulation tissue was detected at the bleeding site. An ulcerated fistula tract ran from the intima to the adventitia, passing through layers of esophageal wall was also noticed. The mortality rate for foreign body ingestion is less than 1%, except in cases of perforation. Therefore the presented case is among rare examples of fatal foreign body ingestions.
食管异物摄入在儿童时期尤为常见,若诊断延迟和治疗延误,可能会导致致命并发症。我们报告一例2岁女孩因大量出血被收入急诊科的病例。然而,她因未被识别的异物导致主动脉食管瘘而死亡。尸检时通过大体检查发现了主动脉食管瘘。从器官和瘘管区域获取了组织样本。在组织病理学检查中,在出血部位发现了一个有多核巨细胞和周围肉芽组织的钙化物体。还注意到一条溃疡的瘘管从内膜延伸到外膜,穿过食管壁各层。除穿孔病例外,异物摄入的死亡率低于1%。因此,本病例是致命性异物摄入的罕见例子之一。