Case report


, 6:18

First online:

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Left subclavian artery-esophageal fistula induced by a paper star: a case report

  • Chen-Sheng LinAffiliated withDivision of Gastroenterology, Kuang Tien General Hospital
  • , Cheng-Wen LinAffiliated withDepartment of Medical Laboratory Science and Biotechnology, China Medical UniversityDepartment of Biotechnology, Asia University Email author 


A subclavian artery-esophageal fistula usually occurs on the right side of an aberrant subclavian artery. It also rarely appears in the site between a non-aberrant subclavian artery and the esophagus due to the ingestion of a foreign body. Upper gastrointestinal bleeding in the case of a subclavian artery-esophageal fistula is rare but often fatal. Here, we report on a 62-year-old male patient with a left subclavian arteryesophageal fistula complicated by hemorrhagic shock. He swallowed a foreign body at a birthday party. An upper gastrointestinal endoscopy indicated a paper star lodged at 20 cm from the incisors, inducing a kissing esophageal ulcer around the esophageal sphincter. One month later, he suffered an unusually strong episode of hematemesis. Subsequently, a computed tomography angiography was performed and demonstrated a left subclavian artery-esophageal fistula. Finally, the fistula induced by the ingestion of a paper star was successfully treated by endovascular stent grafting.


Subclavian arteryesophageal fistula Gastrointestinal bleeding Hemorrhagic shock