Arterio-esophageal fistula (AEF), whether congenital or acquired, is a rare condition which can lead to fatal upper gastrointestinal bleeding. We report here a young man who developed a subclavian-esophageal fistula (SEF) secondary to chicken bone impaction in the upper esophagus. The diagnosis was reached by urgent upper endoscopy and Computed Tomography of the chest which showed pseudo-aneurysmal changes at left subclavian artery with leaked contrast through the fistula towered the esophagus. Urgent endo-vascular angiography confirmed the subclavian arterio-esophageal fistula that was managed uneventfully using covered 6mm Viban stent-graft. The patient survived this serious condition and was discharged home in good condition.
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