{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T10:55:18Z","timestamp":1782471318657,"version":"3.54.5"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,8]],"date-time":"2022-06-08T00:00:00Z","timestamp":1654646400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81701622"],"award-info":[{"award-number":["81701622"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>Aortoesophageal fistula (AEF) caused by esophageal foreign body (EFB) ingestion is a life-threatening condition with a very low survival rate. However, the optimal management strategy remains undetermined. Here, we describe our successful management of a patient with AEF and mediastinitis. A 36-year-old man developed persistent chest and back pain and vomited fresh blood three days after removal of a pork bone in the esophagus under endoscopy in a local hospital. Computed tomography (CT) confirmed bilateral pulmonary infections, mediastinitis, and fistula of the aortic arch. After a multidiscipline discussion, a comprehensive staged strategy was made including salvaged thoracic endovascular aortic repair (TEVAR) to control fatal bleeding, adequate mediastinal debridement, drainage with cervical incision, and video-assisted thoracoscopic surgery, as well as jejunostomy to prevent nasal or gastrostomy reflux from aggravating the mediastinal infection. Furthermore, systematic personalized nutrition support and antibiotics were provided. The patient recovered well and has survived for 50 months until now. Careful assessment should be made with CT to ascertain the risk of AEF before and after the removal of EFB. A salvaged staged strategy of TEVAR with adequate mediastinal debridement and drainage in a less invasive approach may be a safer alternative for AEF patients with infections caused by EFB.<\/jats:p>","DOI":"10.3389\/fsurg.2022.916006","type":"journal-article","created":{"date-parts":[[2022,6,8]],"date-time":"2022-06-08T04:44:05Z","timestamp":1654663445000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Salvaged, Staged, and Safer Management of Aortoesophageal Fistula and Mediastinitis After Removing a Pork Bone: A Case Report"],"prefix":"10.3389","volume":"9","author":[{"given":"Yan","family":"Ge","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayinuer","family":"Tuerdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinming","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingqun","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quanming","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,6,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"307.e15","DOI":"10.1016\/j.avsg.2015.07.025","article-title":"Thoracic aortic pseudoaneurysm after esophageal perforation and mediastinitis caused by accidental ingestion of a mutton bone: a case report on staged endoscopic and endovascular treatments","volume":"30","author":"Mezzetto","year":"2016","journal-title":"Ann Vasc Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1177\/0267659113476329","article-title":"Management options for aorto-oesophageal fistula: case histories and review of the literature","volume":"4","author":"G\u00f6b\u00f6l\u00f6s","year":"2013","journal-title":"Perfusion"},{"key":"B3","doi-asserted-by":"publisher","first-page":"S60","DOI":"10.1007\/s00270-010-9844-8","article-title":"Lethal hemorrhage caused by aortoesophageal fistula secondary to stent-graft repair of the thoracic aorta","volume":"34","author":"Sager","year":"2011","journal-title":"Cardiovasc Intervent Radiol"},{"key":"B4","first-page":"607","article-title":"Proposed management protocol for ingested esophageal foreign body and aortoesophageal fistula: a single-center experience","volume":"1","author":"Wei","year":"2015","journal-title":"Int J Clin Exp Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"233","DOI":"10. 1016\/ s0022-5223(19)37796-7","article-title":"Aorta-esophageal fistula induced by a foreign body. 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