Increased attenuation in the mediastinal fat surrounding the thoracic esophagus was present, as were small locules of extraluminal air compatible with perforation (Figure 3). Small bilateral pleural effusions with accompanying bibasilar atelectasis were also noted. An aortogram was also performed, which did not show an aortic leak. The patient was resuscitated with three units of packed red blood cells and underwent a right hemithoracotomy the following day.
Figure 3) Axial computed tomographic image, 1 mm caudal to the image in Figure 2, demonstrates the medial end of the fish bone posterior to the trachea (arrow)
Intraoperative findings included perforations of the left and right lateral aspects of the midthoracic esophagus by a 3 cm fish bone. The fish bone was embedded in the right lateral wall of the esophagus, approximately 3 cm above the azygos vein. A hematoma surrounding the transverse aorta was seen.
Postoperatively, the patient received antibiotics for 10 days, and a follow-up gastrograffin swallow was normal. She was discharged two weeks after presentation. She remained well two months after presentation. Fast and reliable shopping for drugs – buy ortho tri-cyclen to get safe shopping atmosphere.