Poulet has collected 31
cases in which ulceration caused by foreign bodies in the
esophagus has resulted in perforation of the walls of some of the
neighboring vessels. The order of frequency was as follows:
aorta, 17; carotids, four; vena cava, two; and one case each of
perforation of the inferior thyroid artery, right coronary vein,
demi-azygos vein, the right subclavicular artery (abnormal), and
the esophageal artery. In three of the cases collected there was
no autopsy and the vessel affected was not known.
In a child of three years that had swallowed a half-penny, Atkins
reports rupture of the innominate artery. No symptoms developed,
but six weeks later, the child had an attack of ulcerative
stomatitis, from which it seemed to be recovering nicely, when
suddenly it ejected two ounces of bright red blood in clots, and
became collapsed out of proportion to the loss of blood. Under
treatment, it rallied somewhat, but soon afterward it ejected
four ounces more of blood and died in a few minutes. At the
autopsy 3/4 pint of blood was found in the stomach, and a
perforation was discovered on the right side of the esophagus,
leading into a cavity, in which a blackened half-penny was found.
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