What should be done if a woman swallows a rice ball and gets a fish bone stuck in her aorta?

In general, the emergency treatment for a woman who has forcefully swallowed a rice ball causing a fish bone to pierce into the aorta primarily includes immediate fasting and no fluid intake, maintaining an upright sitting position and rest, calling 120 while specifying the location of the fish bone, continuously monitoring blood pressure and pulse during transport, and cooperating with emergency thoracotomy upon arrival at the hospital to remove the bone. If symptoms such as chest or back pain, hematemesis (vomiting blood), or sudden drop in blood pressure occur, immediate transfer to a capable medical facility is required. Specific measures are analyzed as follows:

1. Immediate fasting and no fluid intake

When a rice ball pushes a fish bone from the esophageal wall into the adventitia of the aorta, any further swallowing may increase blood pressure and enlarge the tear. Fasting and avoiding fluids reduce swallowing actions and lower the risk of secondary bleeding.

2. Maintain an upright sitting position and rest

When lying flat, the pulsating pressure of the heart is directly transmitted along the aorta. Sitting upright uses gravity to slightly reduce intravascular pressure in the thoracic segment, minimizing blood leakage from small perforations and buying time for subsequent surgery.

3. Call 120 and clearly describe the fish bone’s location

The dispatcher can identify this as a high-risk aortic injury based on symptoms such as "retrosternal pain worsened by swallowing," and can pre-alert cardiothoracic surgery and anesthesia teams, thereby shortening the critical window from hospital arrival to thoracotomy.

4. Continuously monitor blood pressure and pulse during transport

Vital signs should be recorded every five minutes in the ambulance. A sudden drop in systolic blood pressure by more than 20 mmHg suggests occult rupture, requiring immediate activation of the massive transfusion protocol upon arrival at the hospital.

5. Cooperate with emergency thoracotomy after arriving at the hospital

Imaging confirmation that the tip of the fish bone protrudes into the esophageal lumen requires surgeons to first initiate cardiopulmonary bypass and clamp the thoracic aorta, then open the esophagus to extract the bone, repair the vessel with a patch graft, and leave a nasogastric tube postoperatively to decompress the stomach and prevent anastomotic leakage.

For one week after surgery, maintain a liquid diet to avoid hot porridge that may dilate blood vessels; avoid lifting heavy objects for one month to reduce fluctuations in thoracic pressure; if persistent dull shoulder or back pain or low-grade fever occurs, enhanced CT must be repeated to rule out pseudoaneurysm formation.