OESOPHAGUS - Pierced by bone

The specimen shows, in the upper part, a piece of bone piercing the oesophagus and extending into the aortic arch.
This woman came to hospital saying that she had swallowed a piece of bone. An X-ray showed no evidence of this and she was discharged. One week later she was readmitted complaining of a nagging substernal pain present on exertion and absent when in bed and slight hemetemesis the day before admission. After 24 hours in hospital she had several hemetemeses and a massive melena and died. At autopsy a piece of mutton bone 1 inches long was found as shown.