Endoscopic extraction of a submucosal esophageal foreign body piercing into the thoracic aorta: A case report

Figure 1 Computed tomography images and thoracic endovascular aortic repair images. A: Emergency thoracic computed tomography (CT) angiography revealed a fishbone in the esophagus involving the wall of the thoracic aorta; B: Enhanced CT angiography revealed that the fishbone had directly penetrated the thoracic aorta after esophagoscopic examination; C: On October 18, 2020, we successfully performed thoracic endovascular aortic repair (TEVAR); D: CT angiography after TEVAR showed that the fishbone was pressed against the edge of the blood vessel.

Figure 2 Images of endoscopy operation. A: Endoscopic examination was performed on October 21, 2020, and a bulge was identified; B: Endoscopic ultrasonography showed a strong echo light cluster protruding beyond the muscularis propria under the bulge; C: The nodule was incised with a dual knife and IT knife to the deep part of the esophageal muscularis; D: A suspicious fishbone with a length of about 1.5 mm was found on the distal side of the nodule; E: The fishbone was pulled out with biopsy forceps; F: The total length of the fishbone was approximately 22 mm.

Figure 3 Images of re-examined computed tomography after the procedure and gastroscope before discharge. A: Computed tomography scan after the procedure show no foreign body in the esophagus and Mediastinum or aorta, which confirmed that we successfully removed the fish bone; B: Re-examined gastrocope before discharge showed that the wounds had healed well.