Aortoesophageal perforation following ingestion of razorblades with massive haemothorax.

Aortoesophageal fistula is a rare complication of foreign body ingestion. Typically having ingested a fish or chicken bone, the patient complains of chest pain or discomfort and/or may present with massive gastrointestinal bleeding, which in all but rare cases is fatal. The pathological mechanism may involve perforation and direct communication of oesophagus and aorta usually at the level of the aortic arch; or more usually following oesophageal perforation, the subsequent mediastinal abscess leads to necrosis of the aortic wall. Torrential haemothorax as a result of such a process has not been previously described, though it has undoubtedly occurred. We present a case of massive haemothorax following deliberate ingestion of razorblades that highlights clinically and radiologically the natural course of such a tragic action.