A 43-year-old woman is admitted to the emergency department with esophageal pain and hematemesis after swallowing a fish bone. An endoscopic examination reveals perforation of the intraabdominal portion of the esophageal wall. Which of the following arteries is most likely injured?
The upper and intermediate portions of the esophagus receive blood supply from three branches of the aorta: the inferior thyroid, bronchial, and esophageal arteries; the lower portion of the esophagus is supplied by the inferior phrenic and left gastric arteries. The lowest part of the esophagus, below the diaphragm, is supplied by the left gastric artery. Perforation to this area could easily injure this artery. The bronchial artery supplies a small section of the esophagus inferior to the level of the carina (T4). The thoracic intercostal arteries supply intercostal spaces and do not contribute to esophageal arterial supply. The right gastric arises from the common hepatic artery and supplies the pyloric part of the lesser curvature of the stomach. The inferior phrenic supplies the portion of the esophagus just superior to the diaphragm.
Branches of left gastric
Bronchial
Thoracic intercostal
Branches of right gastric
Abdomen & Pelvis