Multidisciplinary Management of a Thoracic Aortic-Penetrating Esophageal Foreign Body: A Case Report

Background Thoracic aortic penetration by an esophageal foreign body (EFB) is a rare, fatal emergency (> 80% mortality). This case demonstrates a standardized multidisciplinary approach emphasizing prophylactic thoracic endovascular aortic repair (TEVAR) for hemorrhage prevention. Case presentation A 57-year-old woman developed retrosternal pain after fish ingestion. Computed tomography confirmed a fish bone penetrating the esophagus into the aortic arch lumen. Under multidisciplinary coordination: a covered stent was pre-positioned endovascularly; rigid esophagoscopy extracted the barbed bone; immediate TEVAR sealed aortic leakage post-removal. Postoperative management included dual antibiotics and antiplatelet therapy. Three-month follow-up showed intact stent without complications. Conclusions Prophylactic TEVAR prior to EFB removal is lifesaving in aortic-penetrating injuries, preventing catastrophic hemorrhage in stable patients. This integrated cardiothoracic-otolaryngology protocol offers a replicable model for managing this lethal condition.