Aortoesophageal fistula(AEF)is a rare and fatal disorder. It is also a life-threatening cause of massive upper gastrointestinal hemorrhage.Thoracic aortic aneurysm is the most common cause of AEF.Management of a patie...Aortoesophageal fistula(AEF)is a rare and fatal disorder. It is also a life-threatening cause of massive upper gastrointestinal hemorrhage.Thoracic aortic aneurysm is the most common cause of AEF.Management of a patient with this disorder requires rapid diagnosis and immediate intervention,which is considered the best way to save the patient's life.We report a case of AEF misdiagnosed as esophageal polyp.展开更多
BACKGROUND Aortoesophageal fistula(AEF)induced by esophageal fishbones is a rare complication of esophageal foreign bodies and is very difficult to treat.Although the current view suggests that endovascular stent-graf...BACKGROUND Aortoesophageal fistula(AEF)induced by esophageal fishbones is a rare complication of esophageal foreign bodies and is very difficult to treat.Although the current view suggests that endovascular stent-graft treatment is useful for AEF,whether a subsequent thoracic operation is necessary remains controversial.The purpose of this report is to describe our experience using endovascular stentgraft treatment without combined thoracic operations for the treatment of AEF in two specific cases.CASE SUMMARY We presented two cases of patients complaining of retrosternal discomfort treated in our department for an aortoesophageal fistula caused by the accidental ingestion of a fishbone.The two patients were effectively managed with combined means of endoscopic,medical(broad-spectrum antibiotic therapy,fasting,gastrointestinal decompression,etc.)and endovascular stent-graft treatment.The main difference in treatment was that the first patient presented with hematemesis after endoscopic removal of the fishbone.Subsequently,the patient underwent endovascular stent-graft treatment.The second case was managed with endoscopic removal of the fishbone with simultaneous endovascular stent-graft treatment,without any signs of hematemesis or melena.Both patients had successful postoperative management and were discharged home.Long-term follow-up is ongoing.CONCLUSION The treatment decision-making process should depend on the patients’specific situations.Our practice indicates that endovascular stent-graft treatment without combined thoracic operations could be a valuable alternative in selected patients.展开更多
BACKGROUND Aortoesophageal fistula(AEF)is a rare but life-threatening cause of upper gastrointestinal bleeding.Only a handful of cases of successful management of AEF caused by esophageal cancer have been reported.The...BACKGROUND Aortoesophageal fistula(AEF)is a rare but life-threatening cause of upper gastrointestinal bleeding.Only a handful of cases of successful management of AEF caused by esophageal cancer have been reported.The purpose of this study is to report a case of AEF managed by endovascular aortic repair and review the relevant literature.CASE SUMMARY A 66-year-old man with upper gastroenterology bleeding presented at the Emergency Department of our hospital complaining of chest pain,fever and hematemesis for 6 h.He had vomited 400 mL of bright-red blood and experienced severe chest pain 6 h prior.He had a past medical history of advanced esophageal cancer.He received chemoradiotherapy but stopped 8 mo prior because of intolerance.A chest contrast computed tomographic scan revealed communication between the esophagus and the descending aorta as well as a descending aortic pseudoaneurysm.According to the symptoms and imaging findings,AEF was our primary consideration.The patient underwent aortic angiography,which indicated AEF and descending aortic pseudoaneurysm.Emergency percutaneous thoracic endovascular aortic repair(TEVAR)of the descending aorta was performed,and bleeding was controlled after TEVAR.He received antibiotics and was discharged after treatment.However,he died 2 mo after the TEVAR due to cancer progression.CONCLUSION Although AEF is a lethal condition,timely diagnosis and TEVAR may successfully control bleeding.展开更多
Aortoesophageal fistula(AEF)is a rare cause of massive upper gastrointestinal hemorrhage.Thoracic aortic aneurysm,esophageal foreign body,esophageal cancer and post-surgical complications are common causes of AEF;howe...Aortoesophageal fistula(AEF)is a rare cause of massive upper gastrointestinal hemorrhage.Thoracic aortic aneurysm,esophageal foreign body,esophageal cancer and post-surgical complications are common causes of AEF;however,AEF induced by radiation therapy is a rare phenomenon and seldom described in the literature.It is a catastrophic condition which requires rapid implementation of resuscitative measures,broad-spectrum antibiotics and surgical or endovascular intervention.Transthoracic endovascular aortic repair(TEVAR)is a newer and less invasive technique,which helps to achieve rapid hemostasis in patients with severe hemodynamic instability and offers advantages over conventional repair of the aorta in emergency situations.However initial TEVAR should be followed up with a more definitive surgical repair of the aorta and the esophagus,to lower the mortality rate and achieve better outcomes.We describe here a case of a seventyyear-old male who presented with massive upper gastrointestinal bleeding due to AEF induced by radiation therapy,and his subsequent successful initial management with TEVAR.展开更多
Double aortic arch is a common form of complete vascular ring that encircles both the trachea and the esophagus, and presents with various respiratory and esophageal symptoms, usually in the pediatric population. We p...Double aortic arch is a common form of complete vascular ring that encircles both the trachea and the esophagus, and presents with various respiratory and esophageal symptoms, usually in the pediatric population. We present a case of double aortic arch in an adult patient that manifested as massive upper gastrointestinal bleeding after prolonged nasogastric intubation.展开更多
文摘Aortoesophageal fistula(AEF)is a rare and fatal disorder. It is also a life-threatening cause of massive upper gastrointestinal hemorrhage.Thoracic aortic aneurysm is the most common cause of AEF.Management of a patient with this disorder requires rapid diagnosis and immediate intervention,which is considered the best way to save the patient's life.We report a case of AEF misdiagnosed as esophageal polyp.
文摘BACKGROUND Aortoesophageal fistula(AEF)induced by esophageal fishbones is a rare complication of esophageal foreign bodies and is very difficult to treat.Although the current view suggests that endovascular stent-graft treatment is useful for AEF,whether a subsequent thoracic operation is necessary remains controversial.The purpose of this report is to describe our experience using endovascular stentgraft treatment without combined thoracic operations for the treatment of AEF in two specific cases.CASE SUMMARY We presented two cases of patients complaining of retrosternal discomfort treated in our department for an aortoesophageal fistula caused by the accidental ingestion of a fishbone.The two patients were effectively managed with combined means of endoscopic,medical(broad-spectrum antibiotic therapy,fasting,gastrointestinal decompression,etc.)and endovascular stent-graft treatment.The main difference in treatment was that the first patient presented with hematemesis after endoscopic removal of the fishbone.Subsequently,the patient underwent endovascular stent-graft treatment.The second case was managed with endoscopic removal of the fishbone with simultaneous endovascular stent-graft treatment,without any signs of hematemesis or melena.Both patients had successful postoperative management and were discharged home.Long-term follow-up is ongoing.CONCLUSION The treatment decision-making process should depend on the patients’specific situations.Our practice indicates that endovascular stent-graft treatment without combined thoracic operations could be a valuable alternative in selected patients.
基金Supported by the Natural Science Foundation of Zhejiang Province (No. LQ19H030002)
文摘BACKGROUND Aortoesophageal fistula(AEF)is a rare but life-threatening cause of upper gastrointestinal bleeding.Only a handful of cases of successful management of AEF caused by esophageal cancer have been reported.The purpose of this study is to report a case of AEF managed by endovascular aortic repair and review the relevant literature.CASE SUMMARY A 66-year-old man with upper gastroenterology bleeding presented at the Emergency Department of our hospital complaining of chest pain,fever and hematemesis for 6 h.He had vomited 400 mL of bright-red blood and experienced severe chest pain 6 h prior.He had a past medical history of advanced esophageal cancer.He received chemoradiotherapy but stopped 8 mo prior because of intolerance.A chest contrast computed tomographic scan revealed communication between the esophagus and the descending aorta as well as a descending aortic pseudoaneurysm.According to the symptoms and imaging findings,AEF was our primary consideration.The patient underwent aortic angiography,which indicated AEF and descending aortic pseudoaneurysm.Emergency percutaneous thoracic endovascular aortic repair(TEVAR)of the descending aorta was performed,and bleeding was controlled after TEVAR.He received antibiotics and was discharged after treatment.However,he died 2 mo after the TEVAR due to cancer progression.CONCLUSION Although AEF is a lethal condition,timely diagnosis and TEVAR may successfully control bleeding.
文摘Aortoesophageal fistula(AEF)is a rare cause of massive upper gastrointestinal hemorrhage.Thoracic aortic aneurysm,esophageal foreign body,esophageal cancer and post-surgical complications are common causes of AEF;however,AEF induced by radiation therapy is a rare phenomenon and seldom described in the literature.It is a catastrophic condition which requires rapid implementation of resuscitative measures,broad-spectrum antibiotics and surgical or endovascular intervention.Transthoracic endovascular aortic repair(TEVAR)is a newer and less invasive technique,which helps to achieve rapid hemostasis in patients with severe hemodynamic instability and offers advantages over conventional repair of the aorta in emergency situations.However initial TEVAR should be followed up with a more definitive surgical repair of the aorta and the esophagus,to lower the mortality rate and achieve better outcomes.We describe here a case of a seventyyear-old male who presented with massive upper gastrointestinal bleeding due to AEF induced by radiation therapy,and his subsequent successful initial management with TEVAR.
文摘Double aortic arch is a common form of complete vascular ring that encircles both the trachea and the esophagus, and presents with various respiratory and esophageal symptoms, usually in the pediatric population. We present a case of double aortic arch in an adult patient that manifested as massive upper gastrointestinal bleeding after prolonged nasogastric intubation.
